IndividualActive
Benjamin Bouchard, DDS
NPI 1215627724 · Orthodontics and Dentofacial Orthopedics Dentistry · Grand Rapids, MI
Provider details
- NPI number
- 1215627724
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 2901602468 (MI)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 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
3989 Cascade Rd Se
Grand Rapids, MI 49546-2178
Phone: (616) 459-7171
Fax: (616) 459-7181
Street-level locationGet directions
Mailing address
3989 Cascade Rd Se
Grand Rapids, MI 49546-2178
Registry dates
- Enumerated
- 2023-05-09
- Last updated
- 2025-09-22
- Certified
- 2025-09-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.