NPIMap

Organization Active NPI

Brian Cilla DDS Ms PC

Doing business as West Michigan Periodontics & Advanced Implant Dentistry

  • Periodontics
  • Grandville, MI
National Provider Identifier
1669630489
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
290104700 Issued in MI
Legal business name
BRIAN CILLA DDS MS PC
Doing business as
West Michigan Periodontics & Advanced Implant Dentistry
Practice address
3145 Prairie St SW
Suite 104
Grandville, MI 49418
Phone
(616) 531-1920
Fax
(616) 531-4275
NPI assigned
May 29, 2008
Last updated
May 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Brian Lee Cilla, DDS MSNPI 1215046909
Title
Owner President
Phone
(616) 531-1920

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 290104700 MI Primary

Addresses

Primary practice location

3145 Prairie St SW
Suite 104
Grandville, MI 49418

Mailing address

3145 Prairie St SW
Suite 104
Grandville, MI 49418
Phone (616) 531-1920

Other names 1

  • West Michigan Periodontics & Advanced Implant Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brian Cilla DDS Ms PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1669630489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 PRAIRIE ST SW",
            "address_2": "SUITE 104",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "49418",
            "telephone_number": "616-531-1920",
            "fax_number": "616-531-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 PRAIRIE ST SW",
            "address_2": "SUITE 104",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "49418",
            "telephone_number": "616-531-1920",
            "fax_number": "616-531-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN CILLA DDS MS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "CILLA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "616-531-1920",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "290104700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Michigan Periodontics & Advanced Implant Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.