NPIMap

Organization Active NPI

Gaines Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Grand Rapids, MI
National Provider Identifier
1306213814
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
GAINES PEDIATRIC DENTISTRY PLLC
Practice address
1559 68TH St SE
Grand Rapids, MI 49508-7015
Phone
(616) 258-2005
NPI assigned
Sep 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Authorized official

Name
Dr. Daniel Ocallaghan, DDSNPI 1467714956
Title
Member
Phone
(616) 375-7467

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1559 68TH St SE
Grand Rapids, MI 49508-7015

Mailing address

1100 Giddings Ave SE
Grand Rapids, MI 49506-3255

National Provider Directory

National Provider Directory

Locations

1559 68th St SE
Grand Rapids, MI 49508
Phone (616) 258-2005

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": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1306213814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GIDDINGS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087015",
            "telephone_number": "616-258-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINES PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "OCALLAGHAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "616-375-7467",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 1, 2015; 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.