BLUE BRIDGE DENTAL PLLC – NPI #1477261196
Clinic/Center

BLUE BRIDGE DENTAL PLLC is an AHC clinic located in ALLENDALE, MI. NPPES has assigned the NPI number 1477261196 to BLUE BRIDGE DENTAL PLLC on November 10, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLUE BRIDGE DENTAL PLLC below.

NPI Profile for
BLUE BRIDGE DENTAL PLLC

NPI Number
1477261196
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLUE BRIDGE DENTAL PLLC
Primary location
11160 W.J. PRESLEY PKWY
SUITE 200
ALLENDALE, MI 49401
Phone: (616) 217-3992 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
TIFFANY KIMMEL
CEO
Phone: (570) 847-7815
Updated
Certification Date
Nov 10, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.