DR. MARK JESIN (NPI# 1184885154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184885154 |
Entity Type | Individual |
Full Name | DR. MARK JESIN |
Credential | DDS |
Practice Address |
3855 Burton St Se Ste B Grand Rapids MI 49546 |
Mailing Address |
3855 Burton St Se Ste B Grand Rapids MI 49546-6147 |
Practice Telephone | 6163690360 |
Practice Fax Number | 6163690361 |
Mailing Telephone | 6163690360 |
Mailing Fax Number | 6163690361 |
Enumeration Date | 2008-06-22 |
Last Update Date | 2019-02-13 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
L2299335 | MI | Dental Providers |
Street Address |
3855 BURTON ST SE STE B |
City | GRAND RAPIDS |
State | MI |
Zip Code | 49546 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508324732 | Advanced Oral Surgery, Pllc | Dentist | 3855 Burton St Se Ste B, Grand Rapids, MI 49546-6147 | 2019-03-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
Find all providers in zip 49546 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730440983 | Igor Makovey | Dentist | 4500 Cascade Rd Se Ste 208, Grand Rapids, MI 49546-3665 | 2012-06-05 |
1598084147 | Bradley Michael Robinson | Dentist | 200 43rd Street Se, Suite D, Grand Rapids, MI 49508 | 2010-05-21 |
1629140116 | Robert John Rosema | Dentist | 2017 Eastcastle Dr Se, Suite C, Grand Rapids, MI 49508 | 2006-11-14 |
1679668529 | Oral and Maxillofacial Surgical Associates | Dentist | 813 S Pokegama Ave, Grand Rapids, MN 55744-3934 | 2006-10-04 |
1003908575 | Robert L Kintz | Dentist | 2144 E Paris Ave Se, Suite 150, Grand Rapids, MI 49546-6111 | 2006-09-29 |
1740371087 | Richard W Panek | Dentist | 4349 Sawkaw Dr Ne, Grand Rapids, MI 49525-1768 | 2006-09-28 |
1033223250 | Oral Surgery Associates, PC | Dentist | 2144 E Paris Ave Se Ste 150, Grand Rapids, MI 49546-6126 | 2006-08-17 |
1427002377 | David R Dalrymple | Dentist | 550 3 Mile Rd Nw, Grand Rapids, MI 49544-8207 | 2006-05-22 |
1508324732 | Advanced Oral Surgery, Pllc | Dentist | 3855 Burton St Se Ste B, Grand Rapids, MI 49546-6147 | 2019-03-06 |
1992945943 | Alpine Oral Surgery PC | Dentist | 550 3 Mile Rd Nw, Grand Rapids, MI 49544-8207 | 2009-03-04 |
Find all providers in GRAND RAPIDS |
City | GRAND RAPIDS |
Zip Code | 49546 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.