Active NPI
John Douglas Bouws, DDS
- General Practice Dentistry
- Wyoming, MI
National Provider Identifier
1760596555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Practice address
- 2663 44TH St SW
Ste 204
Wyoming, MI 49519 - Phone
- (616) 538-7320
- Fax
- (616) 538-7666
- NPI assigned
- Aug 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | MI | Primary |
Addresses
Primary practice location
2663 44TH St SW
Ste 204
Wyoming, MI 49519
Mailing address
1560 Waukazoo Dr
Holland, MI 49424
Phone (616) 399-9818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 290100997Z | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760596555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 WAUKAZOO DR",
"city": "HOLLAND",
"state": "MI",
"postal_code": "49424",
"telephone_number": "616-399-9818",
"fax_number": "616-399-9818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2663 44TH ST SW",
"address_2": "STE 204",
"city": "WYOMING",
"state": "MI",
"postal_code": "49519",
"telephone_number": "616-538-7320",
"fax_number": "616-538-7666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUWS",
"first_name": "JOHN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.