Bessie E Afendoulis, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

013942 Issued in MI

Practice address

2249 Wealthy S.E.
Suite 100
Grand Rapids, MI 49506-2931

Phone

(616) 454-8228

Fax

(616) 454-8968

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1457465643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 WEALTHY S.E.",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062931",
            "telephone_number": "616-454-8228",
            "fax_number": "616-454-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2249 WEALTHY S.E.",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062931",
            "telephone_number": "616-454-8228",
            "fax_number": "616-454-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFENDOULIS",
        "first_name": "BESSIE",
        "middle_name": "E",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "013942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.