616 Dental Studio PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

2901020846 Issued in MI

Legal business name

616 DENTAL STUDIO PLLC

Practice address

171 Monroe Ave NW
Grand Rapids, MI 49503-2634

Phone

(616) 214-7865

NPI assigned

Sep 10, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Marcos Cid, D.D.S. M.S.

Title

Dentist

Phone

(616) 214-7865

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1720413636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 MONROE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032634",
            "telephone_number": "616-214-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 MONROE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032634",
            "telephone_number": "616-214-7865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "616 DENTAL STUDIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "CID",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "616-214-7865",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S.  M.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Sep 10, 2013; 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.