PROFESSIONAL DENTAL ASSOCIATES PC NPI 1154592285

NPI Information

  • NPI: 1154592285
  • Provider Name: PROFESSIONAL DENTAL ASSOCIATES PC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Former Legal Business Name: JENSEN SHROGER ANDERSON PC
  • Address: 888 MICHIGAN AVE
    BALDWIN, MI
    ZIP 49304
  • Phone: (231) 745-7231

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NPI Details

PROFESSIONAL DENTAL ASSOCIATES PC is a general practice dentist in Baldwin, MI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PROFESSIONAL DENTAL ASSOCIATES PC NPI is 1154592285. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Jensen Shroger Anderson Pc.

The provider's business location address is:

888 MICHIGAN AVE
BALDWIN, MI
ZIP 49304
Phone: (231) 745-7231
Fax: (231) 745-7246

The provider's authorized official is Kevin T Mathewson .
The authorized official title is Dentist Owner and has the following contact phone number (231) 796-3571.

The enumeration date for this NPI number is 3/17/2008 and was last updated on 3/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice16945MICHIGANNo
21223G0001XDentistGeneral Practice19296MASSACHUSETTSNo
31223G0001XDentistGeneral Practice10102MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18012380OTHERMICHIGANBCBS
22007556OTHERMICHIGANUCCI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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