Pediatric Dentistry Of Michigan Pllc

LBN: Pediatric Dentistry Of Michigan Pllc
Pediatric Dentistry Of Michigan Pllc is an health care organization with primary practice located at 3297 Eagle Run Dr Ne , Grand Rapids MI 49525-7050. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Pediatric Dentistry Of Michigan Pllc can be contacted via phone (917) 597-6749, or through Kim, Wanki via phone (917) 597-6749.

Contact Information

Primary practice address
3297 Eagle Run Dr Ne Grand Rapids MI 49525-7050
Phone: (917) 597-6749
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kim, Wanki Doctor of Dental Surgery (DDS)
Phone: (917) 597-6749

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1831702695
LBN Legal business name Pediatric Dentistry Of Michigan Pllc
DBA Doing business as
Authorized official Kim, Wanki Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2020
Last updated Sep 15th, 2026 - about 2 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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