Marla Ketty Fleming, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2901600924 Issued in MI

Practice address

2064 Baldwin St Ste a
Jenison, MI 49428-8773

Phone

(616) 229-0269

NPI assigned

Mar 27, 2019

Last updated

Jun 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

State licenses

Practice roles

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.

• Willamette Dental Group, P.C.

  • Dentist
  • Lacey, WA
  • NPI 1679409684
  NPD (past)

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1902367584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 UNION AVE SE UNIT 1",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035428",
            "telephone_number": "857-210-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 BALDWIN ST STE A",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288773",
            "telephone_number": "616-229-0269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2020 Division Ave S",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495073029",
            "country_code": "US",
            "telephone_number": "616-229-0049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "MARLA",
        "middle_name": "KETTY",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2022-06-10",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Farnquist, MA COUNSELING, LPC
• Grace Feliz, LLMSW
• Kaley Elizabeth Filiccia
• Kaitlyn A Fiser
• Aleana Fitzgerald, MS, BCBA, LBA
• Jennifer Julie Ford, MA, RDN
• Kristin Foresman
• Roza Forgach
• Toni Marie Freyling, PA-C
• Nicole Fryling, LLPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.