Grand River Periodontics, PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

GRAND RIVER PERIODONTICS, PLLC

Practice address

3050 Ivanrest Ave SW Ste B
Grandville, MI 49418-1400

Phone

(616) 531-1554

NPI assigned

Aug 25, 2021

Last updated

Aug 25, 2021By 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. Rachel Sheridan Sinacola, DDS, MSNPI 1013313642

Title

Owner, Periodontist

Phone

(989) 430-8554

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Rachel Sheridan Sinacola, D.D.S., M.S.

  • Dentist
  • Grand Rapids, MI
  • NPI 1013313642
  NPD Authorized official
• Jeffrey Schaefer Smith, DDS, MS

  • Periodontics
  • Grandville, MI
  • NPI 1700818440
  NPD (past)

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1326715665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 SOMERSET DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033906",
            "telephone_number": "989-430-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 IVANREST AVE SW STE B",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181400",
            "telephone_number": "616-531-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RIVER PERIODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "SINACOLA",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "SHERIDAN",
        "authorized_official_title_or_position": "OWNER, PERIODONTIST",
        "authorized_official_telephone_number": "989-430-8554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jeffsmithddsms@gmail.com",
            "affiliation": "N",
            "address_1": "3050 Ivanrest Ave SW Ste B",
            "city": "Grandville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494181400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Grand View Ophthalmology PLC
• Grandville Chiropractic Clinic
• Grandville Endodontics
• Grandville Eye Care, P.C.
• Grandville Family Dental Care, P.C.

• Periodontics in Grandville, MI
• Providers in Grandville, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.