NPIMap

Organization Active NPI

Benzie-Leelanau District Health Department

  • Dentist
  • Benzonia, MI
National Provider Identifier
1003358482
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019190 Issued in MI
Legal business name
BENZIE-LEELANAU DISTRICT HEALTH DEPARTMENT
Practice address
6051 Frankfort Hwy
Suite 100
Benzonia, MI 49616-9558
Phone
(231) 882-2116
Fax
(231) 882-2204
NPI assigned
Nov 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Daniel R. Thorell Jr.
Title
Health Officer
Phone
(231) 882-4409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901019190 MI Primary

Addresses

Primary practice location

6051 Frankfort Hwy
Suite 100
Benzonia, MI 49616-9558

Mailing address

6051 Frankfort Hwy
Suite 100
Benzonia, MI 49616-9558
Phone (231) 882-2116

Other identifiers 1

IdentifierTypeStateIssuer
1881719086MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Benzie Leelanau District Health Dept6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1003358482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6051 FRANKFORT HWY",
            "address_2": "SUITE 100",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496169558",
            "telephone_number": "231-882-2116",
            "fax_number": "231-882-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 FRANKFORT HWY",
            "address_2": "SUITE 100",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496169558",
            "telephone_number": "231-882-2116",
            "fax_number": "231-882-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENZIE-LEELANAU DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "THORELL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "231-882-4409",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881719086",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benzonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.