GRAND HAVEN SMILES PLC (NPI# 1518311786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518311786 |
| Entity Type | Organization |
| Organization Name | GRAND HAVEN SMILES PLC |
| Practice Address |
921 S Beechtree St Ste 6b Grand Haven MI 49417-2385 |
| Practice Telephone | 6168421188 |
| Practice Fax Number | 6168420417 |
| Mailing Telephone | 6168421188 |
| Mailing Fax Number | 6168420417 |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-04-14 |
| Authorized Official Name | BRADLEY DYKSTRA (OWNER) |
| Authorized Official Telephone | 6166696600 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2901011799 | MI | Dental Providers |
| Street Address |
921 S BEECHTREE ST STE 6B |
| City | GRAND HAVEN |
| State | MI |
| Zip Code | 49417-2385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295393478 | Compassionate Christian Therapy, LLC | Social Worker | 16989 Robbins Rd, Grand Haven, MI 49417 | 2019-06-03 |
| 1275098501 | Christi Rene Fortenbacher | Massage Therapist | 318 S. Beacon Blvd, Grand Haven, MI 49417 | 2019-01-31 |
| 1518440650 | Jessica Hankins | Physical Therapy Assistant | 15773 Charles Ct, Grand Haven, MI 49417 | 2018-09-14 |
| 1558857466 | Christina Steege | Physical Therapist | 514 Friant St, Grand Haven, MI 49417 | 2018-07-03 |
| 1851822548 | Forefront Dermatology, S.c. | Dermatology | 1600 S Beacon Blvd, Suite 160, Grand Haven, MI 49417 | 2017-03-23 |
| 1982057907 | Jeremyn Duane Wiersma | Counselor | 1703 S. Despelder St., Grand Haven, MI 49417 | 2016-07-14 |
| 1760855225 | Lisa Costello | Dental Hygienist | 326 N. Ferry St, Grand Haven, MI 49417 | 2015-11-05 |
| 1508116088 | Great Lakes Chiropractic Health | Chiropractor | 15 S. Seventh St., Grand Haven, MI 49417 | 2012-09-12 |
| 1508120122 | Jonathan Stewart Rouwhorst | Family Medicine | 15161 Willowwood Ct, Grand Haven, MI 49417 | 2012-06-28 |
| 1104108836 | Employee Assistance Center Fulton | Psychologist | 321 Fulton, Grand Haven, MI 49417 | 2011-09-20 |
| Find all providers in zip 49417 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730797655 | Jeffrey J Fritz | Dentist | 927 S Beechtree St, Grand Haven, MI 49417-2386 | 2020-07-16 |
| 1003479833 | Modern Family Dental PC | Dentist | 17272 Robbins Rd Ste 104, Grand Haven, MI 49417-2677 | 2019-04-17 |
| 1013035245 | Seth Adam Vruggink | Dentist | 522 S Beacon Blvd, Grand Haven, MI 49417-1954 | 2007-03-26 |
| 1134283484 | Paul Kevin Creason | Dentist | 601 S Beacon Blvd, Suite 101, Grand Haven, MI 49417-2179 | 2006-12-21 |
| 1134282056 | Frederick Casey Bruhn II | Dentist | 16930 Robbins Rd, Suite 100, Grand Haven, MI 49417-2787 | 2006-12-19 |
| 1316011307 | Walter E Weber | Dentist | 333 Jackson, A Suite, Grand Haven, MI 49417 | 2006-11-20 |
| 1386717098 | Kennard William Creason | Dentist | 333 A Jackson, Grand Haven, MI 49417 | 2006-11-17 |
| 1629151980 | Robert A Kamminga | Dentist | 927 S Beechtree St Ste 5, Grand Haven, MI 49417-2386 | 2006-10-23 |
| 1437243250 | Donald L Wilton | Dentist | 921 S Beechtree St, Suite 6 B, Grand Haven, MI 49417-2385 | 2006-10-03 |
| 1396741146 | John Orr Leitner | Dentist | 575 Robbins Rd, Ste B, Grand Haven, MI 49417-2695 | 2005-06-27 |
| Find all providers in GRAND HAVEN | ||||
| City | GRAND HAVEN |
| Zip Code | 49417 |
Please comment or provide details below to improve the information on GRAND HAVEN SMILES PLC.
| 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.