Jason C Doublestein, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901018806 Issued in MI

Practice address

4320 44TH St SW
Suite 106
Grandville, MI 49418-2300

Phone

(616) 530-2200

Fax

(616) 530-8250

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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.

• 44 West Dental Professionals PC

  • Dentist
  • Grandville, MI
  • NPI 1275914673
  NPD (past) Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450828800000",
    "number": "1386760072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 44TH ST. SW",
            "address_2": "SUITE 105",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "49418",
            "telephone_number": "616-530-2200",
            "fax_number": "616-530-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 44TH ST SW",
            "address_2": "SUITE 106",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182300",
            "telephone_number": "616-530-2200",
            "fax_number": "616-530-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUBLESTEIN",
        "first_name": "JASON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2015-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTISTRY PRACTICE",
            "identifier": "1669598397",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Dodge
• Kyle Dolce, LLP
• Ashley Domin, LPN
• Gursharn Singh Dosanjh, MD
• Barbara J Doss, MD
• Derek Matthew Draft, DDS
• Mary Ann Driggers
• Payton Dueweke
• Molly R Duiven, PA C
• Ashley Dunlap, B.S.

• All providers in Grandville, MI
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.