NPIMap

Organization Active NPI

O'Brien and O'Brien DDS PC

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1497978290
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11607 Issued in MI
Legal business name
O'BRIEN AND O'BRIEN DDS PC
Practice address
1503 Coit Ave NE
Grand Rapids, MI 49505-4906
Phone
(616) 361-2617
Fax
(616) 361-2390
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brenda Saladin
Title
Dental Insurance Specialist
Phone
(616) 361-2617

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 11607 MI Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 11606 MI

Addresses

Primary practice location

1503 Coit Ave NE
Grand Rapids, MI 49505-4906

Mailing address

1503 Coit Ave NE
Grand Rapids, MI 49505-4906
Phone (616) 361-2617

Other identifiers 4

IdentifierTypeStateIssuer
11606OtherMISTATE ID NUMBER
4051278MedicaidMI
4051287MedicaidMI
11607OtherMISTATE ID NUMBER

National Provider Directory

National Provider Directory

Locations

1503 Coit Ave NE
Grand Rapids, MI 49505
Phone (616) 361-2617

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497978290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 COIT AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054906",
            "telephone_number": "616-361-2617",
            "fax_number": "616-361-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 COIT AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054906",
            "telephone_number": "616-361-2617",
            "fax_number": "616-361-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O'BRIEN AND O'BRIEN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALADIN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DENTAL INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "616-361-2617"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11607",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11606",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID NUMBER",
            "identifier": "11606",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4051278",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4051287",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID NUMBER",
            "identifier": "11607",
            "state": "MI"
        }
    ],
    "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 Aug 22, 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.