Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710207097 Individual Practitioner Male Practitioner

Dr. Stuart Pettijohn , DDS

Dentist • Grand Rapids, MI

Professional Overview & Biography Verified Profile Summary

Dr. Stuart Pettijohn, DDS is a registered healthcare professional specializing in Dentist in Grand Rapids, MI. Practice services are available at 4500 CASCADE RD SE STE 100 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4500 Cascade Rd Se Ste 100

Grand Rapids, MI 495463665

Telephone 6169428301
Associated Practice Facility / Clinic
🏢 Stuart Pettijohn Dds Pllc Facility NPI 1295254035

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Grand Rapids, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.0 Yrs
State Avg: 17.7 Yrs
Regional Practice Density
125 Specialists

Practicing in Grand Rapids, MI (3647 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License MI 2901020216

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Secondary Practice Locations

128 S Broad St

Adrian, MI 492212723

Phone: 5172660651

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. James Eldersveld , DDS

Dentist - General Practice

NPI 1740307321

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active September 13, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 13, 2017

Registered at 4500 CASCADE RD SE STE 100, GRAND RAPIDS, MI 495463665 (Tel: (616) 942-8301)

📍
Updated Business Mailing Address September 13, 2017

Registered at 4500 CASCADE RD SE STE 100, GRAND RAPIDS, MI 495463665 (Tel: (616) 942-8301)

👤
Provider Name / Credentials Updated September 13, 2017

Recorded as STUART PETTIJOHN, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2017

Dentist (License #2901020216 in MI)

NPI Profile Active June 09, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location June 09, 2010

Registered at 128 S BROAD ST, ADRIAN, MI 492212723 (Tel: 5172660651)

📍
Updated Business Mailing Address June 09, 2010

Registered at 128 S BROAD ST, ADRIAN, MI 492212723 (Tel: 5172660651)

👤
Provider Name / Credentials Updated June 09, 2010

Recorded as STUART PETTIJOHN, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 09, 2010

Dentist (License #2901020216 in MI)

🟢
Initial NPI Registration & Enumeration June 09, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Stuart Pettijohn. Be the first to share your experience!

Sign in to leave a review for Dr. Stuart Pettijohn

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1710207097
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 09, 2010
Last Update: July 21, 2022
Sole Proprietor: No

Mailing Address

4500 Cascade Rd Se Ste 100

Grand Rapids, MI 495463665

Phone: 6169428301

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.