MATTAWAN FAMILY DENTISTRY NPI 1124836531

NPI Information

  • NPI: 1124836531
  • Provider Name: MATTAWAN FAMILY DENTISTRY
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 56400 CITY CENTER CIR
    MATTAWAN, MI
    ZIP 49071
  • Phone: (269) 568-2609

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NPI Details

MATTAWAN FAMILY DENTISTRY is a general practice dentist in Mattawan, 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. MATTAWAN FAMILY DENTISTRY NPI is 1124836531. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

56400 CITY CENTER CIR
MATTAWAN, MI
ZIP 49071-380
Phone: (269) 568-2609

The provider's authorized official is Jonathan Vandenburgh .
The authorized official title is Owner and has the following contact phone number (269) 568-2609.

The enumeration date for this NPI number is 12/19/2024 and was last updated on 12/19/2024.

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
2124Q00000XDental HygienistNo

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: 11/21/2025

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