Provider Demographics
NPI:1770112419
Name:WINEGAR, CONNIE YOON (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:YOON
Last Name:WINEGAR
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:DR
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:YOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:655 KENMOOR AVE SE STE 102
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8622
Mailing Address - Country:US
Mailing Address - Phone:616-224-3636
Mailing Address - Fax:616-224-3644
Practice Address - Street 1:655 KENMOOR AVE SE STE 102
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8622
Practice Address - Country:US
Practice Address - Phone:616-224-3636
Practice Address - Fax:616-224-3644
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016020671223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics