Bruce A Seitz, DDS
Individual provider Active NPI General Practice Dentistry · Jenison, MI
NPI 1316149602 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1316149602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 14743 (MI)
- Practice address
- 701 Baldwin St
Jenison, MI 49428-7945 - Phone
- (616) 457-5610
- NPI assigned
- May 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160518000819 | MI | Order and Referring Only - Other (Non-Physician) | 0446285316 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14743 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel D Seitz DDS PC | Past |
Accepting new patients | |
| Bruce a Seitz DDS PC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 14743 | MI | Yes |
Addresses
Primary practice location
701 Baldwin St
Jenison, MI 49428-7945
Mailing address
701 Baldwin St
Jenison, MI 49428-7945
Phone (616) 457-5610
Other providers in Jenison, MI
- Edward Phillip Schmitt Jr.
- Carla Marie Schmitz
- Hannah Schultheiss
- Amy Joy Schultz
- Gordon Dale Schultze
- Daniel Delmar Seitz
- Megan Seu
- Ali Jamal Sharief
- Alexis Nicole Shaw
- Michelle Sheridan
All providers in Jenison, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.