John Paul Klooster, DDS
Individual provider Active NPI Dentist · Belmont, MI
NPI 1720151467 · NPPES record last updated Jan 11, 2017
Key facts
- NPI
- 1720151467
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2901017901 (MI)
- Practice address
- 1259 Post Dr NE Ste E
Belmont, MI 49306-8717 - Phone
- (616) 284-3200
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017901 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Belmont Dentistry PLC | Dentist | Past | Accepting new patients |
| Georgetown Family & Cosmetic Dentistry PLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901017901 | MI | Yes |
Addresses
Primary practice location
1259 Post Dr NE Ste E
Belmont, MI 49306-8717
Mailing address
1259 Post Dr NE Ste E
Belmont, MI 49306-8717
Phone (616) 284-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1892650 | Other | UNITED CONCORDIA |
Other providers in Belmont, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.