Individual provider Active NPI

Brian J Buurma, D.D.S., M.S.

  • Endodontics
  • Holland, MI
National Provider Identifier
1477503191
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2901017574 Issued in MI
Practice address
3290 North Wellness Drive
Suite 270
Holland, MI 49424
Phone
(616) 994-9722
Fax
(616) 994-9733
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 2901017574 MI Primary

Addresses

Primary practice location

3290 North Wellness Drive
Suite 270
Holland, MI 49424

Mailing address

3290 N Wellness Dr
Suite 270
Holland, MI 49424-7259
Phone (616) 994-6050

Other identifiers 1

IdentifierTypeStateIssuer
4307374MedicaidMI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160126000155 MI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4688977655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2901017574MIMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian J Buurma DDS Ms Endodontics CurrentSince Aug 18, 2024 Accepting new patients

Locations

3290 N Wellness Dr
Ste 270
Holland, MI 49424
Phone (616) 994-9722

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1477503191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 N WELLNESS DR",
            "address_2": "SUITE 270",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494247259",
            "telephone_number": "616-994-6050",
            "fax_number": "616-994-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 NORTH WELLNESS DRIVE",
            "address_2": "SUITE 270",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-994-9722",
            "fax_number": "616-994-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUURMA",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "2901017574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4307374",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.