Organization Active NPI

Lasting Roots Pediatric Dentistry

  • Pediatric Dentistry
  • Hudsonville, MI
National Provider Identifier
1487568895
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
LASTING ROOTS PEDIATRIC DENTISTRY
Practice address
3810 32ND Ave Ste 500
Hudsonville, MI 49426-8554
Phone
(616) 777-3206
Fax
(616) 777-5305
NPI assigned
Oct 1, 2026
Last updated
Oct 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Authorized official

Name
Jennifer Luca, DMD, MD
Title
Owner/Pediatric Dentist
Phone
(616) 777-3206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

3810 32ND Ave Ste 500
Hudsonville, MI 49426-8554

Mailing address

3810 32ND Ave Ste 500
Hudsonville, MI 49426-8554
Phone (616) 777-3206

NPI Registry JSON

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1487568895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 32ND AVE STE 500",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268554",
            "telephone_number": "616-777-3206",
            "fax_number": "616-777-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 32ND AVE STE 500",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268554",
            "telephone_number": "616-777-3206",
            "fax_number": "616-777-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASTING ROOTS PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A",
        "authorized_official_last_name": "LUCA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "616-777-3206",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudsonville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.