Christopher Niquette

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901021655 Issued in MI

Practice address

2119 64TH Street SW
Byron Center, MI 49315-4931

Phone

(616) 217-3632

NPI assigned

Jun 18, 2015

Sex

Male

Sole proprietor

Yes

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

Opted out of Medicare

Yes, effective Apr 18, 2025 through Apr 18, 2027

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 and National Provider Directory roles.

• Third Coast Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Byron Center, MI
  • NPI 1902551351
  NPD

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1811378508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 64TH ST SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "49315",
            "telephone_number": "616-217-3632",
            "fax_number": "616-217-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 64TH STREET SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493154931",
            "telephone_number": "616-217-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIQUETTE",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901021655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Thu Van Nguyen, MD
• Michelle Nguyen
• Tuyen D Nguyen, D.O.
• Yen Hoang Nguyen, PHARM.D
• Morgan Nicholas, PSYD
• Danielle Norris
• Duane Oetman, M.D.
• Stella Zichat-Asabat Okoh, AGNP
• James Omalley, NP
• Lisa Orange

• Oral and Maxillofacial Surgery (Dentist) in Byron Center, MI
• Providers in Byron Center, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.