Royce A Poel, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10721 Issued in MI

Practice address

2700 5 Mile Rd NE
Grand Rapids, MI 49525-1710

Phone

(616) 361-9290

Fax

(616) 361-1218

NPI assigned

Jan 14, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649321076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 5 MILE RD NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251710",
            "telephone_number": "616-361-9290",
            "fax_number": "616-361-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 5 MILE RD NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251710",
            "telephone_number": "616-361-9290",
            "fax_number": "616-361-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POEL",
        "first_name": "ROYCE",
        "middle_name": "A",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "10721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2681860",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Podgorica
• Zamir Gani Podgorica, M.D.
• Podiatry West Senior Foot Care Services PLLC
• Gabrielle Poeder
• Molly Poel
• Gary David Poelman, M.D.
• Anamaria Pogacean Lorson, LPC
• Nicole Poggi
• Bailey Elisabeth Pogliano, PA
• Elizabeth Pohl, NP

• General Practice Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, 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, 2007; 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.