NPIMap

Organization Active NPI

44 West Dental Professionals PC

  • Dentist
  • Grandville, MI
National Provider Identifier
1275914673
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901018806 Issued in MI
Legal business name
44 WEST DENTAL PROFESSIONALS PC
Practice address
4330 44TH St SW Ste 105
Grandville, MI 49418-2349
Phone
(616) 530-2200
Fax
(616) 530-8250
NPI assigned
Jun 11, 2015
Last updated
Oct 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Authorized official

Name
Jason C Doublestein, DDSNPI 1386760072
Title
Co-Owner
Phone
(616) 530-2200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901018806 MI Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901020644 MI

Addresses

Primary practice location

4330 44TH St SW Ste 105
Grandville, MI 49418-2349

Mailing address

4330 44TH St SW Ste 105
Grandville, MI 49418-2349
Phone (616) 530-2200

National Provider Directory

National Provider Directory

Locations

4330 44th St SW
Ste 105
Grandville, MI 49418
Phone (616) 530-2200

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1275914673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 44TH ST SW STE 105",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182349",
            "telephone_number": "616-530-2200",
            "fax_number": "616-530-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 44TH ST SW STE 105",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182349",
            "telephone_number": "616-530-2200",
            "fax_number": "616-530-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "44 WEST DENTAL PROFESSIONALS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "DOUBLESTEIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "616-530-2200",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018806",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020644",
            "primary": false
        }
    ],
    "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 Oct 9, 2019; 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.