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STUART PETTIJOHN DDS PLLC
NPI 1295254035
Dentist in Grand Rapids, MI

Active since September 13, 2017
4500 CASCADE RD SE STE 100, GRAND RAPIDS, MI 49546(616) 942-8301 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Sep 13, 2017 (2 updates tracked since 2017).

About Stuart Pettijohn Dds Pllc NPPES

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

STUART PETTIJOHN DDS PLLC (NPI 1295254035) is a healthcare organization registered as a dentist in Grand Rapids, Michigan and active in the NPI registry since September 2017. The organization lists Stuart Pettijohn, Dentist, as its authorized official.

NPPES Registry Identity

NPI1295254035
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameSTUART PETTIJOHN DDS PLLC
Location Address4500 CASCADE RD SE STE 100Grand Rapids, MI 49546-3665
Mailing Address4500 Cascade Rd Se Ste 100Grand Rapids, MI 49546-3665 · (616) 942-8301
Phone(616) 942-8301
Organization SubpartNo
Authorized OfficialStuart PettijohnDentist · (616) 890-0750
Enumeration DateSeptember 13, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1295254035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MI · 2901020216
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.
4500 CASCADE RD SE STE 100, Grand Rapids, MI 49546
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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.

STUART PETTIJOHN DDS
Dentist
4500 CASCADE RD SE STE 100
GRAND RAPIDS, MI 49546
Kent County (616) 942-8301

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 Stuart Pettijohn Dds PLLC's NPI number?

The NPI number for Stuart Pettijohn Dds PLLC is 1295254035. It was assigned to this organization in the NPPES registry on September 13, 2017.

Where is Stuart Pettijohn Dds PLLC located?

Stuart Pettijohn Dds PLLC is located at 4500 Cascade Rd SE Ste 100, Grand Rapids, MI 49546. The listed phone number is (616) 942-8301.

What is Stuart Pettijohn Dds PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Stuart Pettijohn Dds PLLC was last updated on July 21, 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.