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GREAT LAKES JAW SURGERY, PC
NPI 1326291816
Dentist - Oral and Maxillofacial Surgery in Grand Rapids, MI

Active since October 28, 2008
2017 EASTCASTLE DR SE, SUITE C, GRAND RAPIDS, MI 49508(616) 281-2370(616) 281-2801 Get Directions Write a Review

NPPES record last updated: July 28, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Great Lakes Jaw Surgery, Pc NPPES

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

GREAT LAKES JAW SURGERY, PC (NPI 1326291816) is a healthcare organization registered as an oral and maxillofacial surgery in Grand Rapids, Michigan and active in the NPI registry since October 2008. The organization lists Robert John Rosema, Owner/ Oral Surgeon, as its authorized official.

NPPES Registry Identity

NPI1326291816
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameGREAT LAKES JAW SURGERY, PC
Location Address2017 EASTCASTLE DR SE, SUITE CGrand Rapids, MI 49508-8872
Mailing Address2017 Eastcastle Dr Se, Suite CGrand Rapids, MI 49508-8872 · (616) 281-2370 · Fax (616) 281-2801
Phone(616) 281-2370
Fax(616) 281-2801
Organization SubpartNo
Authorized OfficialRobert John RosemaOwner/ Oral Surgeon · (616) 281-2370
Enumeration DateOctober 28, 2008
Last NPPES UpdateJuly 28, 2020
NPPES CertifiedJuly 28, 2020
✔ NPI 1326291816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MI · 2901011345
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2017 EASTCASTLE DR SE, Grand Rapids, MI 49508
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Other Identifiers 1

Medicaid10-2978271MI

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 3

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

DR. SCOTT ANTHONY PIROCHTA DDS
Dentist
2017 EASTCASTLE DR SE, SUITE B
GRAND RAPIDS, MI 49508
Kent County (616) 281-0220
DR. DOUGLAS EUGENE LADUE III D.D.S
Dentist (Pediatric Dentistry)
2017 EASTCASTLE DR SE, SUITE A
GRAND RAPIDS, MI 49508
Kent County (616) 455-4646
MR. ROBERT JOHN ROSEMA DDS
Dentist (Oral and Maxillofacial Surgery)
2017 EASTCASTLE DR SE, SUITE C
GRAND RAPIDS, MI 49508
Kent County (616) 281-2370

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 Great Lakes Jaw Surgery, PC's NPI number?

The NPI number for Great Lakes Jaw Surgery, PC is 1326291816. It was assigned to this organization in the NPPES registry on October 28, 2008.

Where is Great Lakes Jaw Surgery, PC located?

Great Lakes Jaw Surgery, PC is located at 2017 Eastcastle Dr SE Suite C, Grand Rapids, MI 49508. The listed phone number is (616) 281-2370.

What is Great Lakes Jaw Surgery, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Great Lakes Jaw Surgery, PC was last updated on July 28, 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.