GREAT LAKES DENTISTRY
NPI 1871865832
Dentist in Shelby Twp, MI

Q: What is Great Lakes Dentistry Shelby's NPI number?

The NPI number for Great Lakes Dentistry Shelby is 1871865832. It was assigned to this organization in the NPPES registry on February 6, 2012. The provider is doing business as Great Lakes Dentistry.

Q: What is Great Lakes Dentistry Shelby's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since February 06, 2012

53620 VAN DYKE AVE, SUITE 2, SHELBY TWP, MI 48316(586) 677-2828 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 25, 2022, Nov 20, 2015 (2 updates tracked since 2015).

On this page

About Great Lakes Dentistry NPPES

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

GREAT LAKES DENTISTRY (NPI 1871865832) is a healthcare organization registered as a dentist in Shelby Twp, Michigan and active in the NPI registry since February 2012. The organization lists Shawn Van De Vyver, President, as its authorized official.

NPPES Registry Identity

NPI1871865832

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameGREAT LAKES DENTISTRY SHELBY

Location Address53620 VAN DYKE AVE, SUITE 2Shelby Twp, MI 48316-1831

Mailing Address73501 Windmill DrBruce Twp, MI 48065-3159 · (734) 320-8939

Phone(586) 677-2828

Organization SubpartNo

Authorized OfficialShawn Van De VyverPresident · (734) 320-8939

Enumeration DateFebruary 6, 2012

Last NPPES UpdateJanuary 25, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 25, 2022

✔ NPI 1871865832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MI · 2901019702

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

53620 VAN DYKE AVE, Shelby Twp, MI 48316

Open in Google Maps ↗

Other Names 1

Doing Business AsGreat Lakes Dentistry

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. JOHN G DIXON D.D.S.

Dentist (General Practice)

53620 VAN DYKE AVE
SHELBY TOWNSHIP, MI 48316

Macomb County (586) 781-5569

RONALD D GEB DDS

Dentist (General Practice)

53620 VAN DYKE AVE
SHELBY TOWNSHIP, MI 48316

Macomb County (248) 651-1525

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 Dentistry Shelby's NPI number?

The NPI number for Great Lakes Dentistry Shelby is 1871865832. It was assigned to this organization in the NPPES registry on February 6, 2012. The provider is doing business as Great Lakes Dentistry.

Where is Great Lakes Dentistry Shelby located?

Great Lakes Dentistry Shelby is located at 53620 Van Dyke Ave Suite 2, Shelby Twp, MI 48316. The listed phone number is (586) 677-2828.

What is Great Lakes Dentistry Shelby's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Great Lakes Dentistry Shelby was last updated on January 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.