Individual provider Active NPI

Christopher Michael Mountford, DDS

  • General Practice Dentistry
  • Grand Haven, MI
National Provider Identifier
1619316007
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020952 Issued in MI
Practice address
333 Jackson St
Ste a
Grand Haven, MI 49417-1067
Phone
(616) 842-0822
NPI assigned
Jun 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901020952 MI Primary

Addresses

Primary practice location

333 Jackson St
Ste a
Grand Haven, MI 49417-1067

Mailing address

333 Jackson St
Ste a
Grand Haven, MI 49417-1067
Phone (616) 842-0822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160531002340 MI Order and Referring Only - Other (Non-Physician) 9436449659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mountford and Ruszkowski Family Dentistry PLLC General Practice CurrentSince Mar 13, 2022 Accepting new patients
James E Mikula DDS PC General Practice Past Accepting new patients
Seva Dental Michigan PC PastSince Feb 18, 2024 Accepting new patients

Locations

333 Jackson Ave
Ste A
Grand Haven, MI 49417
Phone (616) 201-2020

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1619316007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 JACKSON ST",
            "address_2": "STE A",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171067",
            "telephone_number": "616-842-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 JACKSON ST",
            "address_2": "STE A",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171067",
            "telephone_number": "616-842-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNTFORD",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2022-03-09",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.