Affordable Dentures & Implants - Grandville, P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

2901012881 Issued in MI

Legal business name

AFFORDABLE DENTURES & IMPLANTS - GRANDVILLE, P.C.

Practice address

4485 Canal Ave SW Ste C600
Grandville, MI 49418-2691

Phone

(616) 249-2603

NPI assigned

May 18, 2016

Last updated

May 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wallace Walker

Title

DDS/Practice Owner

Phone

(616) 249-2603

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1891142931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 CANAL AVE SW STE C600",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182691",
            "telephone_number": "616-249-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 CANAL AVE SW STE C600",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182691",
            "telephone_number": "616-249-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - GRANDVILLE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_title_or_position": "DDS/PRACTICE OWNER",
        "authorized_official_telephone_number": "616-249-2603"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901012881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Grandville, MI
• Providers in Grandville, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.