Healthcare Provider Details

I. General information

NPI: 1023067402
Provider Name (Legal Business Name): JAMES V. KARHOHS D.D.S., M.S., P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 3 MILE RD NW
GRAND RAPIDS MI
49544-8203
US

IV. Provider business mailing address

976 3 MILE RD NW
GRAND RAPIDS MI
49544-8203
US

V. Phone/Fax

Practice location:
  • Phone: 616-784-4300
  • Fax: 616-785-6060
Mailing address:
  • Phone: 616-784-4300
  • Fax: 616-785-6060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number11577
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: