Organization Active NPI

Coloma Dental PLLC

  • General Practice Dentistry
  • Coloma, MI
National Provider Identifier
1396547451
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COLOMA DENTAL PLLC
Practice address
213 N Paw Paw St
Coloma, MI 49038-9589
Phone
(269) 468-5741
NPI assigned
Mar 26, 2025
Last updated
Mar 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Dr. Hannah Nelson, DDSNPI 1356965180
Title
Owner
Phone
(616) 460-0159

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

213 N Paw Paw St
Coloma, MI 49038-9589

Mailing address

1499 Stark Ave NW
Grand Rapids, MI 49534-2270

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1742947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1396547451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 STARK AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495342270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N PAW PAW ST",
            "city": "COLOMA",
            "state": "MI",
            "postal_code": "490389589",
            "telephone_number": "269-468-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLOMA DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-460-0159",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coloma, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.