Provider Demographics
NPI:1316203227
Name:CHIRENJE, BLESSING TAMBUDZAI (DDS)
Entity Type:Individual
Prefix:
First Name:BLESSING
Middle Name:TAMBUDZAI
Last Name:CHIRENJE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 E SHERMAN BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1963
Mailing Address - Country:US
Mailing Address - Phone:231-737-7745
Mailing Address - Fax:
Practice Address - Street 1:1848 E SHERMAN BLVD STE C
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1963
Practice Address - Country:US
Practice Address - Phone:231-737-7745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI29010217741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program