Nichole Brinkman Lubberts, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

2901021313 Issued in MI

Practice address

2700 5 Mile Rd NE
#202
Grand Rapids, MI 49525-6516

Phone

(813) 951-1716

NPI assigned

May 23, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northview Family Dentistry

  • General Practice Dentistry
  • Grand Rapids, MI
  • NPI 1306241948
  NPD (past) Authorized official

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1336409358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 5 MILE RD NE",
            "address_2": "#202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256516",
            "telephone_number": "813-951-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 5 MILE RD NE",
            "address_2": "#202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256516",
            "telephone_number": "813-951-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBBERTS",
        "first_name": "NICHOLE",
        "middle_name": "BRINKMAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19882",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin P Loyd, PA-C
• Tricia Irene Lozon, PA-C
• LTC Pharmacy LLC
• Luke Lubbers
• Samantha Nicole Lubbers, PA-C
• Rachel Lubinski, DPT
• Dana Caryn Lubner, MA LLP
• Shannon Lubs, DPT
• Melissa Lucas-Espinoza, LMSW
• Ashley Lucas, PA

• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.