Doctor profile · Federal record
Dr. Stuart Pettijohn, DDS
Dentist · Grand Rapids, MI
- NPI 1710207097
- 16 yrs on file
- Male
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
4500 Cascade RD Se Ste 100
Grand Rapids, MI 495463665
(616) 942-8301 - Additional location
-
128 S Broad St
Adrian, MI 492212723
(517) 266-0651
Credentials & registration
- NPI registered
- June 2010 — 16 yrs on file
- Profile last updated
- July 21, 2022
- Specialty taxonomy
- 122300000X — NUCC code
- State license (1)
- Michigan #2901020216
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1710207097. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$132
Transactions
2
Manufacturers
2
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Dentsply Sirona INC | 1 | $118.84 | |
| Elevate Oral Care | 1 | $13.32 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
54
Patients
40
Total drug cost
$102
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Amoxicillin | Generic | 54 | 40 | $102 |
Frequently asked questions
What is Dr. Stuart Pettijohn's medical specialty?
Dr. Stuart Pettijohn practices Dentist in Grand Rapids, MI.
Where does Dr. Stuart Pettijohn practice?
Dr. Stuart Pettijohn practices at 4500 Cascade RD Se Ste 100, Grand Rapids, MI 495463665. Office phone: 6169428301.
What is Dr. Stuart Pettijohn's NPI?
Dr. Stuart Pettijohn's National Provider Identifier (NPI) is 1710207097, issued by NPPES.