Modern Family Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MODERN FAMILY DENTAL PC

Practice address

17272 Robbins Rd Ste 104
Grand Haven, MI 49417-2677

Phone

(616) 820-5744

NPI assigned

Apr 17, 2019

Organization subpart

No

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

Authorized official

Name

Renee Heise

Title

Insurance Specialist

Phone

(231) 865-6945

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher John Sortman, DDS

  • General Practice Dentistry
  • Norton Shores, MI
  • NPI 1528051570
  NPD

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1003479833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17272 ROBBINS RD STE 104",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172677",
            "telephone_number": "616-820-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17272 ROBBINS RD STE 104",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172677",
            "telephone_number": "616-820-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "HEISE",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "INSURANCE SPECIALIST",
        "authorized_official_telephone_number": "231-865-6945"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Alan Minuth, M.D.
• Grace E Miracle
• Ashley Mireles
• Megan Mitchell, MSOT, OTR/L
• Lillie Moaier
• Mikayla Moore, BCABA
• Jill Laura Morell, LLPC
• Courtney Ann Morgan, NP
• Justine Nica Moriarty, IDHS
• Morr Counseling LLC

• General Practice Dentistry in Grand Haven, MI
• Providers in Grand Haven, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; 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.