Healthcare Provider Details

I. General information

NPI: 1568383057
Provider Name (Legal Business Name): BENJAMIN CARL HERRING D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5749 28TH ST SE
GRAND RAPIDS MI
49546-6903
US

IV. Provider business mailing address

117 BENJAMIN AVE SE
GRAND RAPIDS MI
49506-1629
US

V. Phone/Fax

Practice location:
  • Phone: 616-259-5887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901603116
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: