BRENT OPTICAL NPI 1396715199

NPI Information

  • NPI: 1396715199
  • Provider Name: BRENT OPTICAL
  • Classification: Technician/Technologist - 156FX1800X
  • Specialization: Optician
  • Entity Type: Organization
  • Doing Business As: JOHNSTON OPTICAL COMPANY
  • Address: 25 MICHIGAN ST NE
    SUITE 1000
    GRAND RAPIDS, MI
    ZIP 49503
  • Phone: (616) 458-1951

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NPI Details

BRENT OPTICAL is an optician technician technologist in Grand Rapids, MI. The provider is opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy. BRENT OPTICAL NPI is 1396715199. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Johnston Optical Company.

The provider's business location address is:

25 MICHIGAN ST NE
SUITE 1000
GRAND RAPIDS, MI
ZIP 49503-561
Phone: (616) 458-1951
Fax: (616) 458-2089

The provider's authorized official is Brent W. Balkema .
The authorized official title is Owner and has the following contact phone number (616) 458-1951.

The enumeration date for this NPI number is 1/24/2006 and was last updated on 3/30/2009.

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
1156FX1800XTechnician/TechnologistOpticianYes

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
10D16535OTHERMICHIGANBCBSM
2943136666MEDICAIDMICHIGAN

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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