WEST MICHIGAN DERMATOLOGY
NPI 1609896034
Dermatology in Grandville, MI

Q: What is Jack A Dekkinga MD PC's NPI number?

The NPI number for Jack A Dekkinga MD PC is 1609896034. It was assigned to this organization in the NPPES registry on July 20, 2006. The provider is doing business as West Michigan Dermatology.

Q: What is Jack A Dekkinga MD PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since July 20, 2006CLIA Certified · 3 labs

3434 RIVERTOWN POINT CT SW, GRANDVILLE, MI 49418(616) 257-3344(616) 257-1491 Get Directions Write a Review

NPPES record last updated: July 31, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 31, 2024, Apr 13, 2022, Dec 3, 2020 and 1 more (4 updates tracked since 2018).

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About West Michigan Dermatology NPPES

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

WEST MICHIGAN DERMATOLOGY (NPI 1609896034) is a healthcare organization registered as a dermatology in Grandville, Michigan and active in the NPI registry since July 2006. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Gina Charlene Ang, President, as its authorized official.

NPPES Registry Identity

NPI1609896034

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameJACK A DEKKINGA MD PC

Location Address3434 RIVERTOWN POINT CT SWGrandville, MI 49418-3076

Mailing Address3434 Rivertown Point Ct SwGrandville, MI 49418-3076 · (616) 257-3344 · Fax (616) 257-1491

Phone(616) 257-3344

Fax(616) 257-1491

Organization SubpartNo

Authorized OfficialGina Charlene AngPresident · (616) 257-3344

Enumeration DateJuly 20, 2006

Last NPPES UpdateJuly 31, 20244 updates tracked since enumeration

NPPES CertifiedJuly 23, 2024

✔ NPI 1609896034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedSpecialistTaxonomy 174400000X · License 4301039679 (MI)

3434 RIVERTOWN POINT CT SW, Grandville, MI 49418

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Other Names 1

Doing Business AsWest Michigan Dermatology

Secondary Practice Locations 2

Location 13290 N Wellness Dr Ste 240Holland, MI 49424-7261 · Phone (616) 395-9379 · Fax (616) 820-1457

Location 26150 Northland DriveRockford, MI 49341 · Phone (616) 942-9343 · Fax (616) 942-2538

Other Identifiers 3

Other070D16223MI · Bcbs Of Michigan

OtherCI2832NV · Medicare Railroad Group

Other0N86210MI · Medicare Group Number

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 23D0380094

West Michigan Dermatology · Rockford, MI

Active · expires May 10, 2028

CLIA Number23D0380094

Laboratory TypePhysician Office

Certificate Effective DateMay 11, 2026

Certificate Expiration DateMay 10, 2028

Laboratory DirectorJuan G. Vasquez

Laboratory Phone(616) 942-9343

Laboratory LocationWest Michigan Dermatology6150 Northland Drive, Rockford, MI 49341

CLIA data matches this NPI record on: Address Name Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 23D2159414

West Michigan Dermatology · Grandville, MI

Active · expires Mar 31, 2028

CLIA Number23D2159414

Laboratory TypePhysician Office

Certificate Effective DateApril 1, 2026

Certificate Expiration DateMarch 31, 2028

Laboratory DirectorJuan G. Vasquez

Laboratory Phone(616) 257-3344

Laboratory LocationWest Michigan Dermatology3434 Rivertown Point Court SW, Grandville, MI 49418

CLIA data matches this NPI record on: Address Name Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 23D0948745

West Michigan Dermatology · Holland, MI

Active · expires Aug 19, 2027

CLIA Number23D0948745

Laboratory TypePhysician Office

Certificate Effective DateAugust 20, 2025

Certificate Expiration DateAugust 19, 2027

Laboratory DirectorJuan G. Vasquez

Laboratory Phone(616) 395-9379

Laboratory LocationWest Michigan Dermatology3290 N Wellness Drive Bldg D Suite #240, Holland, MI 49424

CLIA data matches this NPI record on: Name Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 10

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

DR. BRANDON WILLIAM MCNALLY M.D.

Dermatology (Dermatopathology)