Thomas Northway, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12024 Issued in MI

Practice address

3050 Ivanrest Ave SW
Grandville, MI 49418-1400

Phone

(616) 531-7480

Fax

(616) 531-4552

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Northway Family Dentistry Professional name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285761718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 IVANREST AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181400",
            "telephone_number": "616-531-7480",
            "fax_number": "616-531-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 IVANREST AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181400",
            "telephone_number": "616-531-7480",
            "fax_number": "616-531-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHWAY",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NORTHWAY FAMILY",
            "last_name": "DENTISTRY",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• April S Norcross, LLC
• Holly Ann Normington, LPC
• Vicky Lynn Norris, DO
• Northland Hearing Centers, Inc.
• Northway Family Dentistry
• Emma Grace Norton, RDH
• Madison Ann Norton
• Jessica Lynn Nostrant, PHARMD
• Rita Lynn Nykamp, COTA/L
• Peyton Oade

• General Practice Dentistry in Grandville, MI
• Providers in Grandville, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.