Healthcare Provider Details

I. General information

NPI: 1225913502
Provider Name (Legal Business Name): KOBIE DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 MIDTOWNE ST NE STE 104
GRAND RAPIDS MI
49503-5731
US

IV. Provider business mailing address

6421 BRIDLEWOOD CT NE
ADA MI
49301-9664
US

V. Phone/Fax

Practice location:
  • Phone: 224-507-2981
  • Fax:
Mailing address:
  • Phone: 224-507-2981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. OLA KOBIERZYCKI
Title or Position: MEMBER
Credential: DDS
Phone: 224-507-2981