Provider Demographics
NPI:1821010174
Name:MAY, DAVID EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:MAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 BRETON CREEK CT SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-9088
Mailing Address - Country:US
Mailing Address - Phone:616-954-9899
Mailing Address - Fax:616-455-0815
Practice Address - Street 1:2351 COUNTRYWOOD DR SE
Practice Address - Street 2:SUITE A
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-5065
Practice Address - Country:US
Practice Address - Phone:616-455-0720
Practice Address - Fax:616-455-0815
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI150531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI726805OtherUNITED CONCORDIA
MI4234026Medicaid
MIJ150530OtherBLUE CROSS PIN