Larry Patrick Dewulf, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901011029 Issued in MI

Practice address

8609 W Grand River
#102-1
Brighton, MI 48116

Phone

(810) 229-5990

Fax

(810) 229-5999

NPI assigned

Apr 30, 2008

Last updated

Apr 30, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1336314350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 W GRAND RIVER",
            "address_2": "#102-1",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "48116",
            "telephone_number": "810-229-5990",
            "fax_number": "810-229-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 W GRAND RIVER",
            "address_2": "#102-1",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "48116",
            "telephone_number": "810-229-5990",
            "fax_number": "810-229-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWULF",
        "first_name": "LARRY",
        "middle_name": "PATRICK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901011029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devotion Home Health and Personal Care Services
• Aaron Deweerd, DO
• Courtney Amanda Dewey, OD
• Riley Grace Dewitt
• Haley Dewolf
• Ravnit Kaur Dhillon, MD
• Diabetic Management Equipment
• Tia N Dickerson, LLMFT, LLPC
• Robert Peter Dickow, LPC, LLP
• Andrea Van Lopik Dillon, LMSW

• General Practice Dentistry in Brighton, MI
• Providers in Brighton, 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 Apr 30, 2008; 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.