Bradley Alan Dykstra, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901011799 Issued in MI

Practice address

3250 Central Blvd
Hudsonville, MI 49426-1439

Phone

(616) 669-6600

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

State licenses

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 and National Provider Directory roles.

• Mi Smiles Dental Cascade PLC

  • General Practice Dentistry
  • Grand Rapids, MI
  • NPI 1528604998
  NPD

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912117128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 CENTRAL BLVD",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261439",
            "telephone_number": "616-669-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 CENTRAL BLVD",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261439",
            "telephone_number": "616-669-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "BRADLEY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901011799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. K Family Dentistry, PLC
• Dr. Robert D. Van Essen DDS PC
• Marilyn Corrine Dracht, OTR/L
• Heather Kathleen Dunakin, PHARMD
• Randall James Duthler, MD
• John Dykstra, DO
• Early Foundations Speech and Feeding Services
• Jennifer A Edwards, PT
• Nicholas English
• Braden Daniel Engstrom

• General Practice Dentistry in Hudsonville, MI
• Providers in Hudsonville, 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 Jul 8, 2007; 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.