NORTHERN MICHIGAN PEDIATRIC DENTISTRY NPI 1275685265

NPI Information

NPI: 1275685265
Provider Name: NORTHERN MICHIGAN PEDIATRIC DENTISTRY
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4944 SKYVIEW CT
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 947-4566
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NORTHERN MICHIGAN PEDIATRIC DENTISTRY is a dental clinic center in Traverse City, MI. NORTHERN MICHIGAN PEDIATRIC DENTISTRY NPI is 1275685265. The provider is registered as an organization entity type.

The provider's business location address is:

4944 SKYVIEW CT
TRAVERSE CITY, MI
ZIP 49684-173
Phone: (231) 947-4566

The provider's authorized official is James M Van Wingen .
The authorized official title is Dentist and has the following contact phone number (231) 947-4566.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 8/22/2020.

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
1	261QD0000X	Clinic/Center	Dental	2901017484	MICHIGAN	Yes

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
1	4457700	OTHER	MICHIGAN	MEDICAID
2	D158620	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD MI

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: 5/5/2024

NPI Synchronization or Removal

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