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KINGMA PEDIATRIC DENTISTRY PLLC
NPI 1811465990
Dentist - Pediatric Dentistry in Grand Rapids, MI

Active since November 07, 2018
1179 E PARIS AVE SE STE 130, GRAND RAPIDS, MI 49546(616) 942-9840(616) 942-0170 Get Directions Write a Review

NPPES record last updated: November 7, 2018. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Kingma Pediatric Dentistry Pllc NPPES

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

KINGMA PEDIATRIC DENTISTRY PLLC (NPI 1811465990) is a healthcare organization registered as a pediatric dentistry in Grand Rapids, Michigan and active in the NPI registry since November 2018. The organization lists Amanda Merren, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1811465990
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameKINGMA PEDIATRIC DENTISTRY PLLC
Location Address1179 E PARIS AVE SE STE 130Grand Rapids, MI 49546-3682
Mailing Address1179 E Paris Ave Se Ste 130Grand Rapids, MI 49546-3682 · (616) 942-9840 · Fax (616) 942-0170
Phone(616) 942-9840
Fax(616) 942-0170
Organization SubpartNo
Authorized OfficialAmanda MerrenOffice Manager · (616) 551-9701
Enumeration DateNovember 7, 2018
✔ NPI 1811465990 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.
1179 E PARIS AVE SE STE 130, 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 3

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

MITTEN KIDS ORTHODONTICS PLC
Dentist (Orthodontics and Dentofacial Orthopedics)
1179 E PARIS AVE SE STE 130
GRAND RAPIDS, MI 49546
Kent County (616) 942-9840
CAREPOINT DENTAL ANESTHESIA GROUP OF MICHIGAN, PLLC
Dentist (Dentist Anesthesiologist)
1179 E PARIS AVE SE STE 130
GRAND RAPIDS, MI 49546
Kent County (616) 226-1370
MITTEN KIDS DENTISTRY CASCADE PLC
Dentist (Pediatric Dentistry)
1179 E PARIS AVE SE STE 130
GRAND RAPIDS, MI 49546
Kent County (616) 942-9840

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 Kingma Pediatric Dentistry PLLC's NPI number?

The NPI number for Kingma Pediatric Dentistry PLLC is 1811465990. It was assigned to this organization in the NPPES registry on November 7, 2018.

Where is Kingma Pediatric Dentistry PLLC located?

Kingma Pediatric Dentistry PLLC is located at 1179 E Paris Ave SE Ste 130, Grand Rapids, MI 49546. The listed phone number is (616) 942-9840.

What is Kingma Pediatric Dentistry PLLC'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 Kingma Pediatric Dentistry PLLC was last updated on November 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.