Organization Active NPI

Mark W. Tournell, D.D.S., PLLC

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1285060780
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
J11639 Issued in MI
Legal business name
MARK W. TOURNELL, D.D.S., PLLC
Practice address
5010 Cascade Rd SE
Grand Rapids, MI 49546-3725
Phone
(616) 942-0840
NPI assigned
Sep 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Authorized official

Name
Dr. Mark Tournell, D.D.S.NPI 1275520199
Title
Owner
Phone
(616) 942-0840

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X J11639 MI Primary

Addresses

Primary practice location

5010 Cascade Rd SE
Grand Rapids, MI 49546-3725

Mailing address

5010 Cascade Rd SE
Grand Rapids, MI 49546-3725

Other identifiers 1

IdentifierTypeStateIssuer
1275520199OtherMINPI TYPE 1

National Provider Directory

National Provider Directory

Locations

5010 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 942-0840

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1285060780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463725",
            "telephone_number": "616-942-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK W. TOURNELL, D.D.S., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "TOURNELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-942-0840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "J11639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1275520199",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.