Michael John Wierenga, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901020644 Issued in MI

Practice address

4320 44TH St SW
Ste 106
Grandville, MI 49418-2300

Phone

(616) 530-2200

Fax

(616) 530-8250

NPI assigned

May 18, 2012

Last updated

May 18, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 44 West Dental Professionals PC

  • Dentist
  • Grandville, MI
  • NPI 1275914673
  NPD (past)

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1578823993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 LAKE VILLAGE DR APT 203",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036539",
            "telephone_number": "616-723-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 44TH ST SW",
            "address_2": "STE 106",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182300",
            "telephone_number": "616-530-2200",
            "fax_number": "616-530-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERENGA",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-18",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric James Wielhouwer, D.O.
• Alyssa Heather Wiener, LMSW
• Jenna Suzann Wierenga, PSYD
• Jon Karl Wierenga, MA, LLP
• Mark John Wierenga, DDS, MS
• Wilcox Counseling Services
• Elizabeth Wilcox
• Sarah E Wilcox, LPC
• William P. McInnis Psy.D, P.C.
• Jenna Williams

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.