NPIMap

Organization Active NPI

Carepoint Dental Anesthesia Group of Michigan, PLLC

  • Dental Anesthesiology
  • Grand Rapids, MI
National Provider Identifier
1487262820
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
Legal business name
CAREPOINT DENTAL ANESTHESIA GROUP OF MICHIGAN, PLLC
Practice address
1179 E Paris Ave SE Ste 130
Grand Rapids, MI 49546-3682
Phone
(616) 226-1370
Fax
(616) 327-6370
NPI assigned
Jul 22, 2020
Last updated
Apr 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Dr. Joshua Jackstien, DMDNPI 1003173576
Title
Owner/Managing Partner
Phone
(720) 414-3611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Anesthesiology 1223D0004X NU Primary

Addresses

Primary practice location

1179 E Paris Ave SE Ste 130
Grand Rapids, MI 49546-3682

Mailing address

8301 E Prentice Ave Ste 215
Greenwood Village, CO 80111-2990
Phone (720) 606-4220

Other identifiers 4

IdentifierTypeStateIssuer
41489268MedicaidCO
13430734MedicaidCO
1750728119OtherHEALTHY KIDS
9000193309MedicaidCO

Other names 2

  • CarePoint Anesthesia Group of Michigan, LLC Other name
  • CarePoint Dental Anesthesia Group of Michigan, PLLC Other name

National Provider Directory

National Provider Directory

Locations

8301 E Prentice Ave
Ste 215
Greenwood Village, CO 80111
Phone (720) 606-4220

Practitioners & affiliated clinicians

Practitioners 8

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": "1595376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1487262820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 E PRENTICE AVE STE 215",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112990",
            "telephone_number": "720-606-4220",
            "fax_number": "720-606-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 E PARIS AVE SE STE 130",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463682",
            "telephone_number": "616-226-1370",
            "fax_number": "616-327-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREPOINT DENTAL ANESTHESIA GROUP OF MICHIGAN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-22",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "JACKSTIEN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER/MANAGING PARTNER",
        "authorized_official_telephone_number": "720-414-3611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41489268",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13430734",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY KIDS",
            "identifier": "1750728119",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000193309",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CarePoint Anesthesia Group of Michigan, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CarePoint Dental Anesthesia Group of Michigan, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 25, 2022; 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.