44 West Dental Professionals PC

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

Organization subpart

No

Name

Jason C Doublestein, DDSNPI 1386760072

Title

Co-Owner

Phone

(616) 530-2200

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason C Doublestein, DDS

  • General Practice Dentistry
  • Grandville, MI
  • NPI 1386760072
  NPD (past) Authorized official
• Michael John Wierenga, D.D.S.

  • Dentist
  • Grandville, MI
  • NPI 1578823993
  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 9, 2019.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1386760072",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1760829444",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1578823993",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Grandville, MI
• Dentist in Michigan

• 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.