Dr. Randy James Breen
Dentist - General Practice
515 Lakeside Dr Se #208
Grand Rapids
, Michigan 49506-2931
Dr. Randy James Breen
Dentist - General Practice
515 Lakeside Dr Se #208
Grand Rapids
, Michigan 49506-2931
(616) 863-9515
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About
Features
Specialties
- General Practice
Languages spoken
- English
Location
First Address
- Dr. Randy James Breen
- 2435 Rolling Meadow Dr Ne
- Belmont, MI
- Zip : 49306-9332
- Phone : (616) 863-9515
Second Address
- Dr. Randy James Breen
- 515 Lakeside Dr Se #208
- Grand Rapids, MI
- Zip : 49506-2931
- Fax : (616) 454-1159
- Phone : (616) 454-9091
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223G0001X | General Practice | 2901014055 | MI |
| Y | 213EG0000X | General Practice | 2901014055 | MI |
National Provider Identifier
| NPI | 1003815655 |
|---|---|
| Provider Name | Dr. Randy James Breen |
| First Address | Belmont, MI 49306-9332 |
| Second Address | Grand Rapids, MI 49506-2931 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/07/2005 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.