LARRY WILDT D.D.S NPI 1780775130

NPI Information

  • NPI: 1780775130
  • Provider Name: LARRY WILDT, D.D.S
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 2515 ALPINE AVE NW
    SUITE A
    GRAND RAPIDS, MI
    ZIP 49544
  • Phone: (616) 364-9348

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NPI Details

Larry Wildt, D.D.S 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. Larry Wildt, D.D.S NPI is 1780775130. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2515 ALPINE AVE NW
SUITE A
GRAND RAPIDS, MI
ZIP 49544-924
Phone: (616) 364-9348
Fax: (616) 364-5950

The enumeration date for this NPI number is 9/28/2006 and was last updated on 7/8/2007.

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 Practice11365MICHIGANYes

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

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