Active NPI
William H Roedema, D.D.S., M.S.
- Prosthodontics
- Grandville, MI
National Provider Identifier
1225203714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 2901009646
- Practice address
- 3739 Basswood Dr SW
Grandville, MI 49418-2003 - Phone
- (616) 531-6377
- NPI assigned
- Apr 25, 2008
- Last updated
- Apr 25, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 2901009646 | MI | Primary |
Addresses
Primary practice location
3739 Basswood Dr SW
Grandville, MI 49418-2003
Mailing address
3739 Basswood Dr SW
Grandville, MI 49418-2003
Phone (616) 531-6377
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901009646 | MI | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209081600000",
"number": "1225203714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3739 BASSWOOD DR SW",
"city": "GRANDVILLE",
"state": "MI",
"postal_code": "494182003",
"telephone_number": "616-531-6377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3739 BASSWOOD DR SW",
"city": "GRANDVILLE",
"state": "MI",
"postal_code": "494182003",
"telephone_number": "616-531-6377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROEDEMA",
"first_name": "WILLIAM",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-25",
"last_updated": "2008-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MI",
"license": "2901009646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grandville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.