Mitten Kids Dentistry Cascade PLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MITTEN KIDS DENTISTRY CASCADE PLC

Practice address

1179 E Paris Ave SE Ste 130
Grand Rapids, MI 49546-3682

Phone

(616) 942-9840

NPI assigned

Apr 18, 2019

Organization subpart

No

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

Authorized official

Name

Brett Kingma, DDS

Title

Owner

Phone

(616) 552-9701

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1710540398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 E PARIS AVE SE STE 130",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463682",
            "telephone_number": "616-942-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 E PARIS AVE SE STE 130",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463682",
            "telephone_number": "616-942-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITTEN KIDS DENTISTRY CASCADE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "KINGMA",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-552-9701",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajesh Mithalal, M.D.
• Genieve Mitrano
• Erica Rose Mitschke
• Rohin Mittal, M.D.
• Silas Mittelstaedt
• Mitten Kids Orthodontics PLC
• Mitten State Pediatric Therapy LLC
• Mitus-Rosendall D.D.S.
• Ariel Tajour Mitz
• Miway Home Care

• Pediatric Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.