Harbor Lights Dental Care PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

HARBOR LIGHTS DENTAL CARE PLLC

Practice address

575 Robbins Rd Suite B
Grand Haven, MI 49417

Phone

(616) 842-2850

Fax

(616) 842-7205

NPI assigned

May 23, 2024

Last updated

May 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Colin William Pellegrom, DDSNPI 1851078422

Title

Owner/Dentist

Phone

(616) 842-2850

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colin William Pellegrom, DDS

  • Dentist
  • Grand Haven, MI
  • NPI 1851078422
  NPD Authorized official
• John Orr Leitner, DDS

  • General Practice Dentistry
  • Grand Haven, MI
  • NPI 1396741146
  NPD (past)

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1265271720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 ROBBINS RD SUITE B",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "49417",
            "telephone_number": "616-842-2850",
            "fax_number": "616-842-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 ROBBINS RD SUITE B",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "49417",
            "telephone_number": "616-842-2850",
            "fax_number": "616-842-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR LIGHTS DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "PELLEGROM",
        "authorized_official_first_name": "COLIN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "616-842-2850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John David Hall, D.C.
• Stacy Lynn Hall, D.C.
• Keegan Hammond
• Jessica Hankins
• Emily Kulka Hann, LMSW
• Harbor View Eye Care Inc.
• Andrew Gene Harrington, PT, DPT
• Kara Harrington, PT, DPT
• Katelyn Harrington, SLP
• Barbara M Harris, MSW CLINICAL LICENSE

• Dental Clinic/Center in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.