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

Mason McGillicuddy, DDS

Individual provider Dentist · NPI 1124557699

Mason McGillicuddy, DDS is a Dentist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2017.

Licensed in
MI
In the registry since
2017
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

100 Cherry St SE
Grand Rapids, MI 49503-4526
Phone: (616) 965-8200
Fax: (616) 940-5366
Show map & directions

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

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence UNKNOWN (MI)

Record details

NPI number1124557699
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJune 8, 2017
Last updated in NPPESJune 8, 2017
Mailing address100 Cherry St Se, Grand Rapids, MI 49503-4526

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