Bridge Street Smiles, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BRIDGE STREET SMILES, PLLC

Practice address

119 E Bridge St
Portland, MI 48875-1434

Phone

(517) 647-4511

NPI assigned

Oct 16, 2024

Last updated

Oct 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Renee Lyn-Irey Owen, DDSNPI 1891956603

Title

Owner

Phone

(517) 526-1234

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Renee Lyn Irey Owen, D.D.S

  • Dentist
  • Charlotte, MI
  • NPI 1891956603
  NPD Authorized official
• Jami M. Schneider, D.D.S.

  • General Practice Dentistry
  • Portland, MI
  • NPI 1033168828
  NPD (past)

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1316767163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9645 TOWNER RD",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "488759481",
            "telephone_number": "517-526-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E BRIDGE ST",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "488751434",
            "telephone_number": "517-647-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE STREET SMILES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "LYN-IREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-526-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger Kay Benner
• Kendra Lynn Billings
• Hannah Bloom
• Jaya Prakash Boddu, PT
• Jesudian Boddu, DPT
• Margery Maureen Briggs, M.S.W.
• Craig Brown, DO
• Rachel M Butzin
• Delores Angela Carbone, LLMSW
• Cardinal Hearing LLC.

• General Practice Dentistry in Portland, MI
• Providers in Portland, 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 Oct 16, 2024; 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.