OrganizationActive
Michel Marie Wicksall DDS PLC
NPI 1053984591 · General Practice Dentistry · Grand Rapids, MI
Provider details
- NPI number
- 1053984591
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Michel Wicksall, Owner(616) 975-9700
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4880 Cascade Rd Se Ste B
Grand Rapids, MI 49546-3701
Phone: (616) 975-9700
Fax: (616) 975-9750
Street-level locationGet directions
Mailing address
4880 Cascade Rd Se Ste B
Grand Rapids, MI 49546-3701
Other names (DBA / former)
- Doing business as
- Michel Marie Wicksall DDS
Registry dates
- Enumerated
- 2021-07-22
- Last updated
- 2021-07-22
- Certified
- 2021-07-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.