Grandville Endodontics

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

GRANDVILLE ENDODONTICS

Practice address

3100 Ivanrest Ave SW
Suite 104
Grandville, MI 49418-2930

Phone

(616) 531-0780

Fax

(616) 531-4677

NPI assigned

Apr 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Brian Joseph Licari, DDSNPI 1437246055

Title

President

Phone

(616) 531-0780

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Brian Joseph Licari, DDS

  • Endodontics
  • Grandville, MI
  • NPI 1437246055
  NPD (past) Authorized official
• Paul F Korte, DDS

  • Endodontics
  • Grandville, MI
  • NPI 1306936141
  NPD (past)

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1508031808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 IVANREST AVE SW",
            "address_2": "SUITE 104",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182930",
            "telephone_number": "616-531-0780",
            "fax_number": "616-531-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 IVANREST AVE SW",
            "address_2": "SUITE 104",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182930",
            "telephone_number": "616-531-0780",
            "fax_number": "616-531-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDVILLE ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "LICARI",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-531-0780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand Rapids Integrative Therapy LLC
• Grand River Endodontics PC
• Grand River Periodontics, PLLC
• Grand View Ophthalmology PLC
• Grandville Chiropractic Clinic
• Grandville Eye Care, P.C.
• Grandville Family Dental Care, P.C.
• Grandville Foot and Ankle, P.C.
• Grandville Pediatric Dentristry
• Grandville Pediatrics, P.C.

• Endodontics in Grandville, MI
• Providers in Grandville, MI by specialty
• Endodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.