MICHEL MARIE WICKSALL DDS PLC NPI 1053984591

NPI Information

  • NPI: 1053984591
  • Provider Name: MICHEL MARIE WICKSALL DDS PLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 4880 CASCADE RD SE STE B
    GRAND RAPIDS, MI
    ZIP 49546
  • Phone: (616) 975-9700

Map and Directions

Get Directions

NPI Details

MICHEL MARIE WICKSALL DDS PLC is a general practice dentist in Grand Rapids, 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. MICHEL MARIE WICKSALL DDS PLC NPI is 1053984591. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4880 CASCADE RD SE STE B
GRAND RAPIDS, MI
ZIP 49546-701
Phone: (616) 975-9700
Fax: (616) 975-9750

The provider's authorized official is Michel Wicksall .
The authorized official title is Owner and has the following contact phone number (616) 975-9700.

The enumeration date for this NPI number is 7/22/2021 and was last updated on 7/22/2021.

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 PracticeYes

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: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.