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PROFESSIONAL DENTAL ASSOCIATES PC
NPI 1992863401
Dentist - General Practice in Big Rapids, MI

Active since December 05, 2006
415 SOUTH STATE STREET, BIG RAPIDS, MI 49307(231) 796-3571(231) 796-2211 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Professional Dental Associates Pc NPPES

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

PROFESSIONAL DENTAL ASSOCIATES PC (NPI 1992863401), doing business as Jensen Shroyer Anderson Pc, is a healthcare organization registered as a general practice in Big Rapids, Michigan and active in the NPI registry since December 2006. The organization lists Kevin Todd Mathewson, Dentist Owner, as its authorized official.

NPPES Registry Identity

NPI1992863401
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePROFESSIONAL DENTAL ASSOCIATES PC
Location Address415 SOUTH STATE STREETBig Rapids, MI 49307-2049
Mailing Address415 South State StreetBig Rapids, MI 49307-2049 · (231) 796-3571 · Fax (231) 796-2211
Phone(231) 796-3571
Fax(231) 796-2211
Organization SubpartNo
Authorized OfficialKevin Todd MathewsonDentist Owner · (231) 796-3571
Enumeration DateDecember 5, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1992863401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in MI · 2901016945✔ Licensed in MI · 2901019404✔ Licensed in MI · 2901010102✔ Licensed in MI · 2901019403
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
415 SOUTH STATE STREET, Big Rapids, MI 49307
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Other Names 1

Former Legal Business NameJensen Shroyer Anderson Pc

Other Identifiers 4

Other1883236MI · United Concordia
OtherD802980MI · Bcbs
OtherD8012380MI · Bcbs
OtherD8012370MI · Bcbs

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 MULTIPLE 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. EDWIN WALTER ANDERSON JR. DDS
Dentist (General Practice)
415 SOUTH STATE STREET
BIG RAPIDS, MI 49307
Mecosta County (231) 296-3571
DR. KEVIN TODD MATHEWSON DDS
Dentist (General Practice)
415 SOUTH STATE STREET
BIG RAPIDS, MI 49307
Mecosta County (231) 796-3571

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 Professional Dental Associates PC's NPI number?

The NPI number for Professional Dental Associates PC is 1992863401. It was assigned to this organization in the NPPES registry on December 5, 2006. The provider was formerly known as Jensen Shroyer Anderson PC.

Where is Professional Dental Associates PC located?

Professional Dental Associates PC is located at 415 South State Street, Big Rapids, MI 49307. The listed phone number is (231) 796-3571.

What is Professional Dental Associates PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Professional Dental Associates PC was last updated on August 22, 2020. 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.