Okemos Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

OKEMOS DENTAL, PLLC

Practice address

4874 Montrose Ave
Okemos, MI 48864-1618

Phone

(517) 349-3110

Fax

(517) 349-4693

NPI assigned

Jul 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Grimm, DDS

Title

Associate

Phone

(517) 349-3110

Specialties & licenses 1

Addresses

Locations

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.

• Bruce Robert Ferguson, DDS

  • Dentist
  • Okemos, MI
  • NPI 1619146412
  NPD (past)

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1528686177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4874 MONTROSE AVE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641618",
            "telephone_number": "517-349-3110",
            "fax_number": "517-349-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4874 MONTROSE AVE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641618",
            "telephone_number": "517-349-3110",
            "fax_number": "517-349-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKEMOS DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "ASSOCIATE",
        "authorized_official_telephone_number": "517-349-3110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatiana Odom
• Frances Odonnell
• Okemos Allergy Center, P.C.
• Okemos Chiropractic Health Clinic, P.C.
• Okemos Chiropractic,PLLC
• Okemos Family Chiropractic Inc
• Okemos Family Dentistry, P.C.
• Okemos Opco, LLC (Medilodge of Okemos)
• Okemos Optometry,PC
• Okemos Osteopathic Center PLC

• General Practice Dentistry in Okemos, MI
• Providers in Okemos, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.