Provider Demographics
NPI:1205065414
Name:VANKALKER, JULIE A (DDS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:VANKALKER
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 1:2545 E PARIS AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6134
Mailing Address - Country:US
Mailing Address - Phone:616-942-4750
Mailing Address - Fax:616-942-5433
Practice Address - Street 1:2545 E PARIS AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6134
Practice Address - Country:US
Practice Address - Phone:616-942-4750
Practice Address - Fax:616-942-5433
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN29010200201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice