West Side Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901020749 Issued in MI

Legal business name

WEST SIDE DENTAL PC

Practice address

515 Michigan St NE Ste 202
Grand Rapids, MI 49503-5721

Phone

(616) 453-5331

Fax

(616) 453-9235

NPI assigned

May 9, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Allyson Burgess Mulder, DMD

Title

Dentist

Phone

(616) 453-5331

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465344000000",
    "number": "1376999433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MICHIGAN ST NE STE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035721",
            "telephone_number": "616-453-5331",
            "fax_number": "616-453-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MICHIGAN ST NE STE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035721",
            "telephone_number": "616-453-5331",
            "fax_number": "616-453-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SIDE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-06-08",
        "status": "A",
        "authorized_official_last_name": "MULDER",
        "authorized_official_first_name": "ALLYSON",
        "authorized_official_middle_name": "BURGESS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "616-453-5331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Michigan Rehab PLLC
• West Michigan Sleep Network PLLC
• West Michigan Spine and Wellness
• West Michigan Surgery Center of Grand Rapids LLC
• West Michigan Urgent Care Inc
• Angela Lynn West, PA
• Ashley West
• Breasia Lee West
• Debra Ann West, MA
• Madelyn Jayne West, DDS

• General Practice Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, 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 Jun 8, 2016; 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.