Individual provider Active NPI

Matthew Veenstra, D.D.S.

  • Dentist
  • Benton Harbor, MI
National Provider Identifier
1477854222
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021433 Issued in MI
Practice address
800 M 139
Benton Harbor, MI 49022-3881
Phone
(269) 849-8251
NPI assigned
Nov 10, 2010
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021433 MI Primary

Addresses

Primary practice location

800 M 139
Benton Harbor, MI 49022-3881

Mailing address

800 M 139
Benton Harbor, MI 49022-3881
Phone (269) 849-8251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141202001525 MI Practitioner - DentistPractitioner - Oral Surgery 7517289515 Reassigns benefits to 1 organization
I20251009004506 TX Practitioner - Dentist 7517289515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1986 Mall PL
Benton Harbor, MI 49022-2332

215 N Sunnybank Rd
Saint Joseph, MI 49085-1852

32652 Kno
Dowagiac, MI 49047-9805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Intercare Community Health Network CurrentSince Nov 3, 2014 Accepting new patients
Intercare Community Health Network CurrentSince Nov 3, 2014 Accepting new patients
Pokagon Band of Potawatomi Indians CurrentSince Sep 8, 2025 Accepting new patients

Locations

308 Charles St
Bangor, MI 49013
Phone (269) 427-7967

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

1986 Mall Pl
Benton Harbor, MI 49022
Phone (269) 945-5854

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

870 Colfax Ave
Benton Harbor, MI 49022
Phone (269) 605-1277

32652 Kno
Dowagiac, MI 49047
Phone (269) 782-4141

7450 Hochberger Rd
Eau Claire, MI 49111
Phone (855) 869-6900

285 James St
Holland, MI 49424
Phone (616) 399-0200

538 Washington St
Otsego, MI 49078
Phone (269) 694-7873

5498 109th Ave
Pullman, MI 49450
Phone (269) 236-5021

Interoperability endpoints

  • Direct secure messaging: matthew.veenstra@ichn.eclinicaldirectplus.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1477854222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490223881",
            "telephone_number": "269-849-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490223881",
            "telephone_number": "269-849-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEENSTRA",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-10",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

Verify at the official NPI Registry.