Dental Impressions, PLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901018623 Issued in MI

Legal business name

DENTAL IMPRESSIONS, PLC

Practice address

1745 Holton Rd
Suite C
Muskegon, MI 49445-1453

Phone

(231) 719-0033

Fax

(231) 719-8933

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michelle L Vandyke, D.D.S.

Title

Sole Proprietor

Phone

(231) 719-0033

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639232457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 HOLTON RD",
            "address_2": "SUITE C",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494451453",
            "telephone_number": "231-719-0033",
            "fax_number": "231-719-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 HOLTON RD",
            "address_2": "SUITE C",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494451453",
            "telephone_number": "231-719-0033",
            "fax_number": "231-719-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL IMPRESSIONS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VANDYKE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "231-719-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Delongpre, D.O.
• Traci Demarr, OTR
• Lillian Ruth Dempsey, LLMSW
• Robert Demuro
• Dental Dreams PLLC
• Laree C Depies, CRNA
• Hailey Depouw
• Dennis Vincent Desimone, DO
• Frederick Michael Detorres, M.D.
• Eric James Dettloff, PA-C

• General Practice Dentistry in Muskegon, MI
• Providers in Muskegon, 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 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.