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DR. JOHN DAVID BRUINSMA DDS
NPI 1114106994
Dentist in Grand Rapids, MI

Active since October 30, 2007PECOS Enrolled
414 PLYMOUTH AVE., NE, GRAND RAPIDS, MI 49505(616) 655-1650(616) 655-1678 Get Directions Write a Review

NPPES record last updated: March 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. John David Bruinsma Dds NPPES

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

DR. JOHN DAVID BRUINSMA DDS (NPI 1114106994) is an individual dentist in Grand Rapids, Michigan, licensed in Michigan (29011013583) and active in the NPI registry since October 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114106994
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JOHN DAVID BRUINSMACredential: DDS
Location Address414 PLYMOUTH AVE., NEGrand Rapids, MI 49505-6038
Mailing Address414 Plymouth Ave., NeGrand Rapids, MI 49505-6038 · (616) 655-1650 · Fax (616) 655-1678
Phone(616) 655-1650
Fax(616) 655-1678
Sole ProprietorYes
Enumeration DateOctober 30, 2007
Last NPPES UpdateMarch 1, 2022
NPPES CertifiedMarch 1, 2022
✔ NPI 1114106994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MI · 29011013583
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
414 PLYMOUTH AVE., NE, Grand Rapids, MI 49505
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Michigan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. John David Bruinsma Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49505 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 John Bruinsma's NPI number?

The NPI number for John Bruinsma is 1114106994. It was assigned to this individual provider in the NPPES registry on October 30, 2007.

Where is John Bruinsma located?

John Bruinsma practices at 414 Plymouth Ave., NE, Grand Rapids, MI 49505. The listed phone number is (616) 655-1650.

What is John Bruinsma's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is John Bruinsma enrolled in Medicare?

Yes. John Bruinsma is registered in the Medicare PECOS enrollment system.

What insurance does John Bruinsma accept?

Health plans from Delta Dental of Michigan list John Bruinsma as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Bruinsma was last updated on March 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.