Healthcare Provider Details

I. General information

NPI: 1881459782
Provider Name (Legal Business Name): ENJOY ORTHODONTICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 44TH ST SW STE 101
GRANDVILLE MI
49418-2300
US

IV. Provider business mailing address

4320 44TH ST SW STE 101
GRANDVILLE MI
49418-2300
US

V. Phone/Fax

Practice location:
  • Phone: 616-743-6569
  • Fax:
Mailing address:
  • Phone: 616-743-6569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: FELIPE PORTO
Title or Position: ORTHODONTIST / OWNER
Credential: DDS, MS, MSD
Phone: 616-743-6569