Organization Active NPI

Dental Group Associates PC

  • Pediatric Dentistry
  • Grand Rapids, MI
National Provider Identifier
1487128120
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

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

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.

Verify at the official NPI Registry.