Individual provider Active NPI

Connie May Verhagen, D.D.S.

  • Pediatric Dentistry
  • Muskegon, MI
National Provider Identifier
1952489122
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14475 Issued in MI
Practice address
755 Seminole Rd.
Suite 101
Muskegon, MI 49441
Phone
(231) 780-3200
Fax
(231) 780-3299
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 14475 MI Primary

Addresses

Primary practice location

755 Seminole Rd.
Suite 101
Muskegon, MI 49441

Mailing address

755 Seminole Rd.
Suite 101
Muskegon, MI 49441
Phone (231) 780-3200

Other identifiers 1

IdentifierTypeStateIssuer
4341269MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14475MIMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Pediatric Dentistry, P.C. Pediatric Dentistry Past Accepting new patients
Brianne Ferguson DDS PLLC Pediatric Dentistry PastSince Jan 29, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952489122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SEMINOLE RD.",
            "address_2": "SUITE 101",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "49441",
            "telephone_number": "231-780-3200",
            "fax_number": "231-780-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SEMINOLE RD.",
            "address_2": "SUITE 101",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "49441",
            "telephone_number": "231-780-3200",
            "fax_number": "231-780-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERHAGEN",
        "first_name": "CONNIE",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "14475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4341269",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.