Individual provider Active NPI

Jennifer Joy Vantimmeren, DDS

  • Dentist
  • Zeeland, MI
National Provider Identifier
1861656779
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019820 Issued in MI
Practice address
225 N State St
Zeeland, MI 49464-1214
Phone
(616) 772-2868
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019820 MI Primary

Addresses

Primary practice location

225 N State St
Zeeland, MI 49464-1214

Mailing address

225 N State St
Zeeland, MI 49464-1214
Phone (616) 772-2868

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160518000835 MI Order and Referring Only - DentistPractitioner - Dentist 0143519934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1861656779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N STATE ST",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494641214",
            "telephone_number": "616-772-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N STATE ST",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494641214",
            "telephone_number": "616-772-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTIMMEREN",
        "first_name": "JENNIFER",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zeeland, MI

Sources for this page

Verify at the official NPI Registry.