Rediske Dental Professional Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

REDISKE DENTAL PROFESSIONAL CORPORATION

Practice address

6543 28TH Ave
Hudsonville, MI 49426-8856

Phone

(616) 443-6546

NPI assigned

Mar 2, 2020

Last updated

Mar 2, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Ryan Rediske, DDSNPI 1114364593

Title

President

Phone

(616) 443-6546

Specialties & licenses 1

Addresses

Practitioners 3

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.

• Michael Ryan Rediske, D.D.S.

  • General Practice Dentistry
  • Wpafb, OH
  • NPI 1114364593
  Authorized official Same address or phone
• Cameron Daniel Shoemaker, DDS

  • Dentist
  • Hudsonville, MI
  • NPI 1467292888
  NPD (past)
• Clifford J Vanputten, DDS

  • General Practice Dentistry
  • Hudsonville, MI
  • NPI 1740499722
  NPD (past)

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1427682251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6543 28TH AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268856",
            "telephone_number": "616-443-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6543 28TH AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268856",
            "telephone_number": "616-443-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDISKE DENTAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "REDISKE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-443-6546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lee Raad, MA, LLC
• Joash Ajay Raj, MD
• Lucas Anthony Raskey
• Luke Tanner Rasper
• Rebuild and Restore Counceling, LLC
• Rehab 4 Performance
• Renewed Physical Therapy LLC
• William Jon Renkema, RN
• Adam Rezmer
• Kathleen Anne Ridlington, CCC-SLP

• Dental Clinic/Center in Hudsonville, MI
• Providers in Hudsonville, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.