Organization Active NPI

North Park Family Dental PLLC

  • Dentist
  • Grand Rapids, MI
National Provider Identifier
1407773872
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
NORTH PARK FAMILY DENTAL PLLC
Practice address
422 N Park St NE
Grand Rapids, MI 49525-2580
Phone
(616) 361-7265
NPI assigned
Jul 6, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Authorized official

Name
Dr. Joshua Robert Dame, DDSNPI 1063347870
Title
Associate Dentist
Phone
(616) 361-7265

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

422 N Park St NE
Grand Rapids, MI 49525-2580

Mailing address

422 N Park St NE
Grand Rapids, MI 49525-2580
Phone (616) 361-7265

National Provider Directory

National Provider Directory

Locations

422 N Park St NE
Grand Rapids, MI 49525
Phone (616) 361-7265

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1783296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1407773872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 N PARK ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252580",
            "telephone_number": "616-361-7265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 N PARK ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252580",
            "telephone_number": "616-361-7265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PARK FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-06",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "DAME",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "ASSOCIATE DENTIST",
        "authorized_official_telephone_number": "616-361-7265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "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 6, 2026; 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.