Provider Demographics
NPI:1700662632
Name:FERRIS, DUNYA MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUNYA
Middle Name:MARTIN
Last Name:FERRIS
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 1:6569 ROUND HILL CT
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7128
Mailing Address - Country:US
Mailing Address - Phone:616-808-1577
Mailing Address - Fax:
Practice Address - Street 1:1124 28TH ST SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-2855
Practice Address - Country:US
Practice Address - Phone:616-530-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601739122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty