Active NPI
Dental Group Associates PC
- Pediatric Dentistry
- Grand Rapids, MI
National Provider Identifier
1487128120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- DENTAL GROUP ASSOCIATES PC
- Practice address
- 4505 Cascade Rd SE # B
Grand Rapids, MI 49546-8381 - Phone
- (616) 268-2090
- NPI assigned
- Jan 16, 2019
- Last updated
- Jun 16, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Papes
- Title
- Director of Operations
- Phone
- (616) 268-2092
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | NU | Primary |
Addresses
Primary practice location
4505 Cascade Rd SE # B
Grand Rapids, MI 49546-8381
Mailing address
128 Columbus Ave
Grand Haven, MI 49417-1224
Phone (616) 268-2092
National Provider Directory
National Provider DirectoryLocations
4505 Cascade Rd SE
#B
Grand Rapids, MI 49546
Phone (616) 215-1312
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- General Practice Dentistry
- Grand Haven, MI
- NPI 1265595102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1592265600000",
"number": "1487128120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 COLUMBUS AVE",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494171224",
"telephone_number": "616-268-2092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4505 CASCADE RD SE # B",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468381",
"telephone_number": "616-268-2090"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DENTAL GROUP ASSOCIATES PC",
"organizational_subpart": "NO",
"enumeration_date": "2019-01-16",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A",
"authorized_official_last_name": "PAPES",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "616-268-2092"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
- Makayla Pearl Denson
- Dominique Dent, LMSW
- Taylor Elizabeth Dent, LMSW
- Dental Design P.C.
- Dental Expressions
- Dental Group West, P.C.
- Dental Health Professionals of Michigan, P.C. (Partners in Dental Care)
- Dental Medical Services Inc. (Diversified Medical Staffing, LLC)
- Johanna Kathleen Denton, MA
- Dentures-in-a-Day, PLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.