Individual provider Active NPI

Steven John Debbink, D.D.S

  • Dentist
  • Holland, MI
National Provider Identifier
1215910559
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3972 Issued in WI
Practice address
285 James St
Holland, MI 49424-1849
Phone
(616) 399-0200
Fax
(616) 399-5055
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3972 WI Primary

Addresses

Primary practice location

285 James St
Holland, MI 49424-1849

Mailing address

50 Industrial Park Rd
Bangor, MI 49013-1246
Phone (269) 427-7937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130128000422 MI Practitioner - Oral Surgery 4486808474 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3972WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Intercare Community Health Network Current Accepting new patients
Intercare Community Health Network CurrentSince Jan 2, 2013 Accepting new patients
Intercare Community Health Network CurrentSince Jan 2, 2013 Accepting new patients

Locations

308 Charles St
Bangor, MI 49013
Phone (269) 427-7967

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

870 Colfax Ave
Benton Harbor, MI 49022
Phone (269) 605-1277

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

7450 Hochberger Rd
Eau Claire, MI 49111
Phone (855) 869-6900

285 James St
Holland, MI 49424
Phone (616) 399-0200

538 Washington St
Otsego, MI 49078
Phone (269) 694-7873

5498 109th Ave
Pullman, MI 49450
Phone (269) 236-5021

Interoperability endpoints

  • Direct secure messaging: steven.debbink@ichn.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1215910559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 INDUSTRIAL PARK RD",
            "city": "BANGOR",
            "state": "MI",
            "postal_code": "490131246",
            "telephone_number": "269-427-7937",
            "fax_number": "269-427-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494241849",
            "telephone_number": "616-399-0200",
            "fax_number": "616-399-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBBINK",
        "first_name": "STEVEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "3972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.