Mark John Wierenga, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2901020872 Issued in MI

Practice address

3131 44TH St SW
Grandville, MI 49418-2684

Phone

(616) 301-8900

NPI assigned

May 16, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Armbrecht & Wierenga Orthodontics

  • Dental Clinic/Center
  • Grandville, MI
  • NPI 1073909297
  NPD (past) Authorized official

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1669119152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 PENNY LN SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "494189383",
            "telephone_number": "616-862-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 44TH ST SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182684",
            "telephone_number": "616-301-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 43rd St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495088700",
            "country_code": "US",
            "telephone_number": "616-301-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIERENGA",
        "first_name": "MARK",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901020872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Leigh Wieber, PH.D., LLP
• Eric James Wielhouwer, D.O.
• Alyssa Heather Wiener, LMSW
• Jenna Suzann Wierenga, PSYD
• Jon Karl Wierenga, MA, LLP
• Michael John Wierenga, D.D.S.
• Wilcox Counseling Services
• Elizabeth Wilcox
• Sarah E Wilcox, LPC
• William P. McInnis Psy.D, P.C.

• Orthodontics and Dentofacial Orthopedics Dentistry in Grandville, MI
• Providers in Grandville, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.