Evan David Ouderkirk, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901600514APP20 Issued in MI

Practice address

11970 Sweetwater Dr
Grand Ledge, MI 48837-8199

Phone

(517) 627-2470

NPI assigned

May 28, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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.

• Ouderkirk Dental PLLC

  • General Practice Dentistry
  • Grand Ledge, MI
  • NPI 1003573403
  NPD Authorized official
• Scott T Stevenson DDS PLLC

  • Dental Clinic/Center
  • Grand Ledge, MI
  • NPI 1770180523
  NPD

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1790308492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 GRENOBLE CIR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11970 SWEETWATER DR",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488378199",
            "telephone_number": "517-627-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUDERKIRK",
        "first_name": "EVAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600514APP20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Denise Munro, NP
• Quan D Nguyen, MD
• Nancy Novakoski, OTR
• Orthodontic Specialists of Mid-Michigan, PC
• Ouderkirk Dental PLLC
• Elizabeth Paine, D.O
• Erin Parcell, LPC
• Mindy Parshall
• Teresa L Patterson, LMSW
• Philip R Shriner DDS PC

• General Practice Dentistry in Grand Ledge, MI
• Providers in Grand Ledge, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.