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Deactivated NPI 1770661043 Deactivated / Inactive NPI Male Practitioner

Dr. Andrew Jack Vanderwal , DDS

Dentist • Jenison, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Andrew Vanderwal has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 02, 2006
NPI Deactivation Date October 12, 2017
Total Practice Duration ~11 Years of Practice (2006 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Andrew Vanderwal, DDS was a registered Dentist practicing in Jenison, MI. Throughout an active medical career spanning 11 years, Dr. Vanderwal provided care at the practice location at 7678 COTTONWOOD DRIVE until profile deactivation on 2017-10-12.

Practice Location & Contact Primary Location

Practice Address

7678 Cottonwood Drive

Jenison, MI 49428

Telephone 6164574600
Fax 6164576021
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Jenison, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.7 Yrs
Regional Practice Density
15 Specialists

Practicing in Jenison, 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 2901007770

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.

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1831277136

Doctor of Dental Surgery

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated October 12, 2017

Record deactivated on October 12, 2017

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 7678 COTTONWOOD DRIVE, JENISON, MI 49428 (Tel: 6164574600)

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Updated Business Mailing Address July 08, 2007

Registered at 496 MIEDE, JENISON, MI 49428 (Tel: 6164572939)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ANDREW VANDERWAL, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #2901007770 in MI)

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Initial NPI Registration & Enumeration November 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770661043
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 02, 2006
Last Update: July 08, 2007
Deactivation Date: October 12, 2017

Mailing Address

496 Miede

Jenison, MI 49428

Phone: 6164572939

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.