Michelle L Vandyke, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901018623 Issued in MI

Practice address

1124 28TH St SW
Wyoming, MI 49509-2855

Phone

(616) 530-9900

Fax

(616) 656-5765

NPI assigned

Mar 13, 2007

Last updated

Oct 24, 2024By the provider in NPPES

Sex

Female

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Pro Dental Mi 1 PC

  dba Destiny Dental of Wyoming

  • General Practice Dentistry
  • Wyoming, MI
  • NPI 1326875600
  NPD
• John F. Schondelmayer, D.D.S., PC

  • General Practice Dentistry
  • White Cloud, MI
  • NPI 1568413938
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1831222454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 FOWLER ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494453059",
            "telephone_number": "231-286-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 28TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495092855",
            "telephone_number": "616-530-9900",
            "fax_number": "616-656-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Austin Vanderweide, DC
• Colleen Vandoren
• Chelsea Vandriel, DPT
• Carmen Vandyke
• Dale Vandyke, OD
• Jennifer Vandyken
• Jordan Vandyken
• Jeanine Vanloon
• Madeline Laurel Vanloon, PHARMD
• Ciara Vannatter, LMSW

• General Practice Dentistry in Wyoming, MI
• Providers in Wyoming, 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 Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.