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PORT PEDIATRIC DENTISTRY PC
NPI 1669080651
Dentist - Pediatric Dentistry in Holland, MI

Active since July 16, 2020
291 W LAKEWOOD BLVD, HOLLAND, MI 49424(616) 392-1100(616) 396-1117 Get Directions Write a Review

NPPES record last updated: July 16, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Port Pediatric Dentistry Pc NPPES

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

PORT PEDIATRIC DENTISTRY PC (NPI 1669080651) is a healthcare organization registered as a pediatric dentistry in Holland, Michigan and active in the NPI registry since July 2020. The organization lists Suzanne Kristen Port, Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1669080651
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePORT PEDIATRIC DENTISTRY PC
Location Address291 W LAKEWOOD BLVDHolland, MI 49424-1969
Mailing Address291 W Lakewood BlvdHolland, MI 49424-1969 · (616) 392-1100 · Fax (616) 396-1117
Phone(616) 392-1100
Fax(616) 396-1117
Organization SubpartNo
Authorized OfficialSuzanne Kristen PortDentist/owner · (616) 392-1100
Enumeration DateJuly 16, 2020
NPPES CertifiedJuly 16, 2020
✔ NPI 1669080651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
291 W LAKEWOOD BLVD, Holland, MI 49424
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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 5

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

PHARES FAMILY DENTISTRY
Dentist (General Practice)
291 W LAKEWOOD BLVD
HOLLAND, MI 49424
Ottawa County (616) 396-7502
DR. PHILIP C WISNIEWSKI DDS, FAGD, PC
Dentist (General Practice)
291 W LAKEWOOD BLVD
HOLLAND, MI 49424
Ottawa County (616) 396-9583
THOMAS CHASE PHARES DDS
Dentist (General Practice)
291 W LAKEWOOD BLVD
HOLLAND, MI 49424
Ottawa County (616) 396-7502
DR. SUZANNE K PORT DDS MS
Dentist (Pediatric Dentistry)
291 W LAKEWOOD BLVD
HOLLAND, MI 49424
Ottawa County (616) 392-1100
CHELSEA FOX
Massage Therapist
291 W LAKEWOOD BLVD
HOLLAND, MI 49424
Ottawa County (989) 424-1099

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 Port Pediatric Dentistry PC's NPI number?

The NPI number for Port Pediatric Dentistry PC is 1669080651. It was assigned to this organization in the NPPES registry on July 16, 2020.

Where is Port Pediatric Dentistry PC located?

Port Pediatric Dentistry PC is located at 291 W Lakewood Blvd, Holland, MI 49424. The listed phone number is (616) 392-1100.

What is Port Pediatric Dentistry PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Port Pediatric Dentistry PC was last updated on July 16, 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.