Healthcare Provider Details

I. General information

NPI: 1265595102
Provider Name (Legal Business Name): DARREN M RIOPELLE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 S BEECHTREE ST
GRAND HAVEN MI
49417
US

IV. Provider business mailing address

128 COLUMBUS AVE
GRAND HAVEN MI
49417-1224
US

V. Phone/Fax

Practice location:
  • Phone: 616-850-3970
  • Fax: 616-850-3976
Mailing address:
  • Phone: 616-268-2090
  • Fax: 616-215-1320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16820
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: