NPIMap

Organization Active NPI

Seva Dental Michigan PC

Doing business as Grand Rapids Dental Team

  • Dentist
  • Grand Rapids, MI
National Provider Identifier
1457178667
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SEVA DENTAL MICHIGAN PC
Doing business as
Grand Rapids Dental Team
Practice address
1100 4 Mile Rd NW
Grand Rapids, MI 49544-7397
Phone
(616) 784-6377
NPI assigned
Sep 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Kelly Rolnicki
Title
Director of Revenue Cycle
Phone
(708) 372-4773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1100 4 Mile Rd NW
Grand Rapids, MI 49544-7397

Mailing address

1100 4 Mile Rd NW
Grand Rapids, MI 49544-7397
Phone (616) 784-6377

Other names 1

  • Grand Rapids Dental Team Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Seva Dental Michigan PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1100 4 Mile Rd NW
Grand Rapids, MI 49544
Phone (616) 301-2225

NPI Registry JSON

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1457178667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 4 MILE RD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495447397",
            "telephone_number": "616-784-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 4 MILE RD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495447397",
            "telephone_number": "616-784-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVA DENTAL MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "ROLNICKI",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "708-372-4773"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Rapids Dental Team",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 20, 2024; 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.