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GREAT LAKES DENTISTRY
NPI 1083003222
Dentist - General Practice in Shelby Township, MI

Active since January 12, 2015
53620 VAN DYKE AVE STE 2, SHELBY TOWNSHIP, MI 48316(586) 677-2828 Get Directions Write a Review

NPPES record last updated: February 19, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Great Lakes Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES DENTISTRY (NPI 1083003222) is a healthcare organization registered as a general practice in Shelby Township, Michigan and active in the NPI registry since January 2015. The organization lists Shawn Van De Vyver, President, as its authorized official.

NPPES Registry Identity

NPI1083003222
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameVAN DE VYVER DENTAL, P.C.
Location Address53620 VAN DYKE AVE STE 2Shelby Township, MI 48316-1831
Mailing Address53620 Van Dyke Ave Ste 2Shelby Township, MI 48316-1831 · (586) 677-2828
Phone(586) 677-2828
Organization SubpartNo
Authorized OfficialShawn Van De VyverPresident · (734) 320-8939
Enumeration DateJanuary 12, 2015
Last NPPES UpdateFebruary 19, 2020
✔ NPI 1083003222 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MI · 2901019702
Definition
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.
53620 VAN DYKE AVE STE 2, Shelby Township, MI 48316
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Other Names 1

Doing Business AsGreat Lakes Dentistry

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SHAWN THOMAS VAN DE VYVER DDS
Dentist
53620 VAN DYKE AVE STE 2
SHELBY TOWNSHIP, MI 48316
Macomb County (586) 677-2828

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Van De Vyver Dental, P.C.'s NPI number?

The NPI number for Van De Vyver Dental, P.C. is 1083003222. It was assigned to this organization in the NPPES registry on January 12, 2015. The provider is doing business as Great Lakes Dentistry.

Where is Van De Vyver Dental, P.C. located?

Van De Vyver Dental, P.C. is located at 53620 Van Dyke Ave Ste 2, Shelby Township, MI 48316. The listed phone number is (586) 677-2828.

What is Van De Vyver Dental, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Van De Vyver Dental, P.C. was last updated on February 19, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.