Active NPI
Mary Kathryn Palaszek, DDS
- General Practice Dentistry
- Grand Rapids, MI
National Provider Identifier
1376766519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901015832
- Practice address
- 1636 Leonard NW
Grand Rapids, MI 49504 - Phone
- (616) 453-2255
- Fax
- (616) 453-9719
- NPI assigned
- Apr 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901015832 | MI | Primary |
Addresses
Primary practice location
1636 Leonard NW
Grand Rapids, MI 49504
Mailing address
11425 No Loprette Dr
Manistee, MI 49660
Phone (231) 723-6533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901015832 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376766519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11425 NO LOPRETTE DR",
"city": "MANISTEE",
"state": "MI",
"postal_code": "49660",
"telephone_number": "231-723-6533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1636 LEONARD NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49504",
"telephone_number": "616-453-2255",
"fax_number": "616-453-9719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALASZEK",
"first_name": "MARY",
"middle_name": "KATHRYN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901015832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.