OrganizationActive
Pro Dental Mi 1 PC
NPI 1164259438 · General Practice Dentistry · Kalamazoo, MI
Pro Dental Mi 1 PC is a General Practice Dentistry organization in Kalamazoo, MI (NPI 1164259438).
Provider details
- NPI number
- 1164259438
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Simone Wilson-Adeleke, Director of Credentialing(732) 731-8398
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr 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
3130 S Westnedge Ave
Kalamazoo, MI 49008-4927
Phone: (269) 459-9200
Fax: (269) 459-9195
Street-level locationGet directions
Mailing address
10 Woodbridge Center Dr Ste 520
Woodbridge, NJ 07095-1152
Other names (DBA / former)
- Doing business as
- Destiny Dental of Kalamazoo
Registry dates
- Enumerated
- 2024-09-19
- Last updated
- 2024-09-19
- Certified
- 2024-09-19
Frequently asked questions
- What is Pro Dental Mi 1 PC's NPI number?
- Pro Dental Mi 1 PC's National Provider Identifier (NPI) is 1164259438, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pro Dental Mi 1 PC?
- Pro Dental Mi 1 PC is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Pro Dental Mi 1 PC located?
- Pro Dental Mi 1 PC's practice location on file with NPPES is 3130 S Westnedge Ave, Kalamazoo, MI 49008-4927.
- What is Pro Dental Mi 1 PC's phone number?
- The practice phone number listed in the NPPES registry for Pro Dental Mi 1 PC is (269) 459-9200.
- Who is the authorized official for Pro Dental Mi 1 PC?
- The authorized official listed on Pro Dental Mi 1 PC's NPPES record is Simone Wilson-Adeleke, Director of Credentialing. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pro Dental Mi 1 PC's NPI active?
- Yes — Pro Dental Mi 1 PC's NPI (1164259438) is active in the NPPES registry as of the last update on 2024-09-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.