BRANT A ERBENTRAUT (NPI# 1609961374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609961374 |
| Entity Type | Individual |
| Full Name | BRANT A ERBENTRAUT |
| Credential | D.D.S. |
| Practice Address |
2140 Lake Michigan Dr Nw Grand Rapids MI 49504-4785 |
| Practice Telephone | 6167352870 |
| Practice Fax Number | 6167352871 |
| Mailing Telephone | 6167352870 |
| Mailing Fax Number | 6167352871 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2901018125 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 0D111530 | 01 |
| MI | BCBSD | 181250 | 01 |
| Street Address |
2140 LAKE MICHIGAN DR NW |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49504-4785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598772626 | Oral & Maxillofacial Surgery Associates of Western Michigan Plc | Oral & Maxillofacial Surgery | 2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785 | 2006-08-02 |
| 1972789949 | Victor H Mastaglio | Dentist | 2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785 | 2008-01-21 |
| 1720173529 | Lonny E Zietz | Dentist | 2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785 | 2006-10-04 |
| 1053406728 | Paul Jeffrey Brooks | Dentist | 2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785 | 2006-10-04 |
| 1891880654 | James Mark Domin | Dentist | 2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785 | 2006-10-04 |
| 1316032139 | Steven W Schultz | Dentist | 2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477049518 | Mark Contreras | Nurse Practitioner | 72 Sheldon Blvd Se # 130, Grand Rapids, MI 49504 | 2018-07-02 |
| 1205338753 | Kelli Marie Selby | Physical Therapist | 235 Wealthy, Grand Rapids, MI 49504 | 2018-03-01 |
| 1871094474 | Kymiri Lyn Coles | Physical Therapist | 1000 Edison Ave Ne, Grand Rapids, MI 49504 | 2018-02-28 |
| 1881132744 | Courtney Glinka | Behavior Technician | 1149 Butterworth St Sw, Grand Rapids, MI 49504 | 2017-02-10 |
| 1649650300 | Alyson Renee Vela | Social Worker | 1256 Walker Ave Ne, Grand Rapids, MI 49504 | 2015-06-08 |
| 1508258500 | Grand Rapids Natural Health | Nutritionist | 638 Fulton Street W., Grand Rapids, MI 49504 | 2015-02-27 |
| 1144622598 | Robert Mclaren | Physical Therapist | 2807 Lake Michigan Dr Nw Ste 1, Grand Rapids, MI 49504 | 2014-09-17 |
| 1972854339 | Beth Ellen Gregory | Registered Nurse | 1956 Walker Avenue Northwest, Grand Rapids, MI 49504 | 2012-09-26 |
| 1588914147 | Unlimited Alternatives | Community/Behavioral Health | 282 Leonard, Grand Rapids, MI 49504 | 2012-09-11 |
| 1386912178 | Michael Allen Crawford | Pharmacist | 800 West Leonard Nw, Grand Rapids, MI 49504 | 2011-12-07 |
| Find all providers in zip 49504 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730440983 | Igor Makovey | Dentist | 4500 Cascade Rd Se Ste 208, Grand Rapids, MI 49546-3665 | 2012-06-05 |
| 1598084147 | Bradley Michael Robinson | Dentist | 200 43rd Street Se, Suite D, Grand Rapids, MI 49508 | 2010-05-21 |
| 1184885154 | Mark Jesin | Dentist | 3855 Burton St Se Ste B, Grand Rapids, MI 49546 | 2008-06-22 |
| 1629140116 | Robert John Rosema | Dentist | 2017 Eastcastle Dr Se, Suite C, Grand Rapids, MI 49508 | 2006-11-14 |
| 1679668529 | Oral and Maxillofacial Surgical Associates | Dentist | 813 S Pokegama Ave, Grand Rapids, MN 55744-3934 | 2006-10-04 |
| 1003908575 | Robert L Kintz | Dentist | 2144 E Paris Ave Se, Suite 150, Grand Rapids, MI 49546-6111 | 2006-09-29 |
| 1740371087 | Richard W Panek | Dentist | 4349 Sawkaw Dr Ne, Grand Rapids, MI 49525-1768 | 2006-09-28 |
| 1033223250 | Oral Surgery Associates, PC | Dentist | 2144 E Paris Ave Se Ste 150, Grand Rapids, MI 49546-6126 | 2006-08-17 |
| 1427002377 | David R Dalrymple | Dentist | 550 3 Mile Rd Nw, Grand Rapids, MI 49544-8207 | 2006-05-22 |
| 1508324732 | Advanced Oral Surgery, Pllc | Dentist | 3855 Burton St Se Ste B, Grand Rapids, MI 49546-6147 | 2019-03-06 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49504 |
Please comment or provide details below to improve the information on BRANT A ERBENTRAUT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.