Eugene Ro, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019.033080 Issued in IL

Practice address

3152 Peregrine Dr NE Ste 200
Grand Rapids, MI 49525-9723

Phone

(616) 447-3660

NPI assigned

Jun 1, 2021

Last updated

Oct 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Brennan Family & Cosmetic Dentistry, PC

  dba Knapp Dental Lodge

  • General Practice Dentistry
  • Grand Rapids, MI
  • NPI 1174224265
  NPD

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1700452729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 ORLANDO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 PEREGRINE DR NE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259723",
            "telephone_number": "616-447-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RO",
        "first_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-01",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601986",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Paul Rizik, DO
• Syed Ali Rizvi, M.D.
• Atif Rizwan, MD
• RLD LLC (Passionate Life Counseling)
• RLJ Counseling and Psychological
• Alyssa Roach
• Carly Richelle Roach, LMSW
• Marie Roach, CNP
• Sonja Andrea Robart
• Hannah Robb, PT, DPT

• Dentist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.