Dettmann Center

Primary specialty

Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X

License

4301051003

Legal business name

DETTMANN CENTER

Practice address

3501 Lake Eastbrook Blvd SE Ste 100
Grand Rapids, MI 49546-5939

Phone

(616) 350-3230

NPI assigned

Oct 9, 2014

Organization subpart

No

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

Authorized official

Name

Sandra K Dettmann, M.D.

Title

Owner

Phone

(616) 350-3230

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1427452176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465939",
            "telephone_number": "616-350-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 LAKE EASTBROOK BLVD SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465939",
            "telephone_number": "616-350-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETTMANN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-09",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "DETTMANN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-350-3230",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": null,
            "license": "4301051003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destinee's Cleaning LLC Dba Destinee's Compassionate Cleaning
• Sandra Deters
• Timberly Kay Deters, RN
• Danielle Dettloff, OTR/L
• Lori Dettloff, R.PH.
• Danielle Suzanne Dettmann
• Kaitey Alexis Dettmann
• Jason David Dettwiler, D.C.
• Jane Elizabeth Detweiler, LPC
• Alexis Deuel

• Anesthesiology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.