Great Northern Dental Assoc PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREAT NORTHERN DENTAL ASSOC PC

Practice address

1100 1St Ave North
Escanaba, MI 49829

Phone

(906) 786-3814

Fax

(906) 786-3881

NPI assigned

Sep 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gary W Bradley, DDS

Title

President

Phone

(906) 786-3814

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Annette E Dufour, DDS

  • General Practice Dentistry
  • Escanaba, MI
  • NPI 1487677688
  NPD (past)
• Raluca Stuleanu, DDS

  • General Practice Dentistry
  • Menomonee Falls, WI
  • NPI 1003826223
  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013011139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 1ST AVE NORTH",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-786-3814",
            "fax_number": "906-786-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 1ST AVE NORTH",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-786-3814",
            "fax_number": "906-786-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT NORTHERN DENTAL ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-786-3814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Lakes Gynecology & Aesthetics Inc, PC
• Great Lakes Podiatry PLLC
• Great Lakes Podiatry PLLC
• Great Lakes Recovery Centers
• Great Lakes Recovery Centers
• Great Smile Dentistry
• Greenlund Enterprises, Inc
• James Grider
• Lynn Makela Grund, MD
• Guardian Flight LLC

• Dentist in Escanaba, MI
• Providers in Escanaba, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.