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PEDIATRIC DENTISTRY OF MICHIGAN PLLC
NPI 1831702695
Dentist - Pediatric Dentistry in Grand Rapids, MI

Active since August 30, 2020
3297 EAGLE RUN DR NE, GRAND RAPIDS, MI 49525(917) 597-6749 Get Directions Write a Review

NPPES record last updated: January 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 25, 2021, Aug 30, 2020 (2 updates tracked since 2020).

About Pediatric Dentistry Of Michigan Pllc NPPES

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

PEDIATRIC DENTISTRY OF MICHIGAN PLLC (NPI 1831702695) is a healthcare organization registered as a pediatric dentistry in Grand Rapids, Michigan and active in the NPI registry since August 2020. The organization lists Wanki Kim, Owner, as its authorized official.

NPPES Registry Identity

NPI1831702695
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePEDIATRIC DENTISTRY OF MICHIGAN PLLC
Location Address3297 EAGLE RUN DR NEGrand Rapids, MI 49525-7050
Mailing Address3297 Eagle Run Dr NeGrand Rapids, MI 49525-7050 · (917) 597-6749
Phone(917) 597-6749
Organization SubpartNo
Authorized OfficialWanki KimOwner · (917) 597-6749
Enumeration DateAugust 30, 2020
Last NPPES UpdateJanuary 25, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2021
✔ NPI 1831702695 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.
3297 EAGLE RUN DR NE, Grand Rapids, MI 49525
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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 2

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

DR. AMY KAY DEYOUNG DDS, MS
Dentist (Pediatric Dentistry)
3297 EAGLE RUN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 447-7900
WILLIAM KIM DDS PLLC
Dentist (Pediatric Dentistry)
3297 EAGLE RUN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 377-4759

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 Pediatric Dentistry Of Michigan PLLC's NPI number?

The NPI number for Pediatric Dentistry Of Michigan PLLC is 1831702695. It was assigned to this organization in the NPPES registry on August 30, 2020.

Where is Pediatric Dentistry Of Michigan PLLC located?

Pediatric Dentistry Of Michigan PLLC is located at 3297 Eagle Run Dr NE, Grand Rapids, MI 49525. The listed phone number is (917) 597-6749.

What is Pediatric Dentistry Of Michigan 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 Pediatric Dentistry Of Michigan PLLC was last updated on January 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.