Provider Demographics
NPI:1225026958
Name:JAMES STRIKWERDA D.D.S., P.C.
Entity Type:Organization
Organization Name:JAMES STRIKWERDA D.D.S., P.C.
Other - Org Name:STRIKWERDA FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELUSHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-392-8668
Mailing Address - Street 1:181 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-7117
Mailing Address - Country:US
Mailing Address - Phone:616-392-8668
Mailing Address - Fax:616-392-1691
Practice Address - Street 1:181 W 35TH ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7117
Practice Address - Country:US
Practice Address - Phone:616-392-8668
Practice Address - Fax:616-392-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI132071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty