Gary Lee Zoutendam, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

GZ10510 Issued in MI

Practice address

491 E Columbia Ave
Ste 3
Battle Creek, MI 49015

Phone

(269) 962-8505

Fax

(269) 962-9160

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1225131782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 E COLUMBIA AVE",
            "address_2": "STE 3",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49015",
            "telephone_number": "269-962-8505",
            "fax_number": "269-962-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 E COLUMBIA AVE",
            "address_2": "STE 3",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49015",
            "telephone_number": "269-962-8505",
            "fax_number": "269-962-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOUTENDAM",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "GZ10510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4045261",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tenneil Lynn Zielaskowski, REGISTERED DIETITIAN
• Cheryl Ann Zimlich, PMHNP
• Kori Zimmerman, MA, LLP
• Abigail Schein Zimskind, M.D.
• Matthew Hershel Zitny

• Oral and Maxillofacial Surgery (Dentist) in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.