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

Oral & Maxillofacial Surgery Associates of Western Michigan PLC

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1598772626

Oral & Maxillofacial Surgery Associates of Western Michigan PLC is an Oral & Maxillofacial Surgery (D.M.D.) in Grand Rapids, Michigan. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

2140 Lake Michigan Dr NW
Grand Rapids, MI 49504-4785
Phone: (616) 791-9600
Fax: (616) 791-9603
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X

Record details

NPI number1598772626
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official J Domin — Member · (616) 791-9600
NPI enumeratedAugust 2, 2006
Last updated in NPPESApril 12, 2010
Mailing address2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785

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