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GLEN VALLEY DENTISTRY NPI 1538100482


NPI Information

NPI: 1538100482
Provider Name: GLEN VALLEY DENTISTRY
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
9041 N RODGERS CT SE
CALEDONIA, MI
ZIP 49316
Phone: (616) 891-8931
Get Directions

GLEN VALLEY DENTISTRY is a general practice dentist in Caledonia, MI. The provider is 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. GLEN VALLEY DENTISTRY NPI is 1538100482. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9041 N RODGERS CT SE
CALEDONIA, MI
ZIP 49316-660
Phone: (616) 891-8931
Fax: (616) 891-9803

The provider's authorized official is Robin T. Vaughan .
The authorized official title is Owner/dentist and has the following contact phone number (616) 891-8931.

The enumeration date for this NPI number is 6/10/2006 and was last updated on 4/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice2901014542MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========OTHERMICHIGANTAX ID #
2D801041OTHERMICHIGANBCBS OF MI
3846910OTHERMICHIGANUNITED CONCORDIA #
44836800MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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