FIRST FRUITS DENTAL, PC (NPI# 1851815450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851815450 |
| Entity Type | Organization |
| Organization Name | FIRST FRUITS DENTAL, PC |
| Other Organization Name | BOWTIE DENTAL |
| Practice Address |
1621 44th St Sw Ste 200 Wyoming MI 49509-4387 |
| Practice Telephone | (616) 532-9003 |
| Mailing Telephone | 6165329003 |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-07-26 |
| Authorized Official Name | RACHEL BRUEN (HR) |
| Authorized Official Telephone | 6165329003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Bowtie Dental | Doing Business As Name - Organization |
| Street Address |
1621 44TH ST SW STE 200 |
| City | WYOMING |
| State | MI |
| Zip Code | 49509-4387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023620713 | Lindsay Kayann Ottowitz | Behavior Technician | 1428 44th St. Sw, Wyoming, MI 49509 | 2020-08-23 |
| 1750990016 | Lindsay Alexandra Lyszczarz | Behavior Technician | 5281 Clyde Park Ave Se, Suite 2, Wyoming, MI 49509 | 2020-07-23 |
| 1033690409 | Courtney M Garner | Behavior Technician | 1428 44th Street, Wyoming, MI 49509 | 2018-08-23 |
| 1457857195 | Ashley Mae Autio | Case Manager/Care Coordinator | 795 36th Street, Wyoming, MI 49509 | 2018-04-02 |
| 1689124588 | Jacqeulyn Harmon | Behavioral Analyst | 2819 Peckheath Rd Sw Apt D, Wyoming, MI 49509 | 2016-10-04 |
| 1275988925 | Intsar Abdulahe | Social Worker | 1551 Charles Russell, Wyoming, MI 49509 | 2016-05-02 |
| 1992160071 | Concierge Home Care Services of West Michigan, LLC | Home Infusion | 1360 56th Street Sw, Wyoming, MI 49509 | 2015-12-16 |
| 1417349796 | Yashana Duncan | Case Manager/Care Coordinator | 225 Colrain St. Sw, Suite 2, Wyoming, MI 49509 | 2015-02-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| 1366882755 | Kevin Timothy Solt | Dentist | 1535 44th St Sw Ste 200, Wyoming, MI 49509 | 2013-06-28 |
| Find all providers in zip 49509 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1174185490 | Michael Kroeze | Dentist | 5675 Burlingame Ave Sw Ste C, Wyoming, MI 49509-9706 | 2019-07-08 |
| 1609364009 | Alexandra K Hylen | Dentist | 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 | 2018-05-01 |
| 1013363761 | Byron Center Family Dental Pllc | Dentist | 4489 Byron Center Ave Sw, Suite A, Wyoming, MI 49519-4804 | 2016-05-12 |
| 1366882755 | Kevin Timothy Solt | Dentist | 1535 44th St Sw Ste 200, Wyoming, MI 49509 | 2013-06-28 |
| 1982960894 | D2 Dental of Michigan | Dentist | 1124 28th St Sw, Suite 38a, Wyoming, MI 49509-2855 | 2012-04-04 |
| 1427291343 | Todd R Vandermeer | Dentist | 1869 Porter St Sw, Wyoming, MI 49519-1709 | 2009-04-07 |
| 1659574721 | Jason Alan Dew | Dentist | 900 52nd St Sw, Wyoming, MI 49509-9725 | 2007-06-07 |
| 1194937821 | Chad Edward Loween | Dentist | 5305 E Viking Blvd, Wyoming, MN 55092-8014 | 2007-05-04 |
| 1043342942 | James J. Hur | Dentist | 1402 36th St Sw, Wyoming, MI 49509-3407 | 2007-03-09 |
| Find all providers in WYOMING | ||||
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| 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.