Individual provider Active NPI

John Alfred Ostrowski, D.D.S

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1881817070
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015378 Issued in MI
Practice address
2249 Wealthy St SE
Suite 100
Grand Rapids, MI 49506-3052
Phone
(616) 454-8228
Fax
(616) 454-8968
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 015378 MI Primary

Addresses

Primary practice location

2249 Wealthy St SE
Suite 100
Grand Rapids, MI 49506-3052

Mailing address

2249 Wealthy St SE
Suite 100
Grand Rapids, MI 49506-3052
Phone (616) 454-8228

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150504000219 MI Order and Referring Only - Other (Non-Physician) 0840519435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015378MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1881817070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 WEALTHY ST SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063052",
            "telephone_number": "616-454-8228",
            "fax_number": "616-454-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2249 WEALTHY ST SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063052",
            "telephone_number": "616-454-8228",
            "fax_number": "616-454-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROWSKI",
        "first_name": "JOHN",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "015378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.