Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Modern Periodontics

Organization Periodontics · NPI 1679855761

Modern Periodontics is a Periodontics in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2011.

Licensed in
MI
In the registry since
2011

Practice location Address checks out

2356 32nd St Ste #100
Grand Rapids, MI 49508-1510
Phone: (616) 241-5658
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 16791 (MI)

Record details

NPI number1679855761
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Erin Moerdyke — Office Manager · (616) 241-5658
NPI enumeratedSeptember 14, 2011
Last updated in NPPESSeptember 14, 2011
Mailing address2356 32nd Street, Suite #100, Grand Rapids, MI 49508

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