NPIMap

Organization Active NPI

Ideal Dentistry of Norton Shores

  • Dental Clinic/Center
  • Norton Shores, MI
National Provider Identifier
1013591908
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
IDEAL DENTISTRY OF NORTON SHORES
Practice address
755 Seminole Rd Ste 102
Norton Shores, MI 49441-6561
Phone
(231) 780-1100
NPI assigned
May 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Dr. Amanda Robertson, DDSNPI 1548828098
Title
Dentist
Phone
(989) 313-1843

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

755 Seminole Rd Ste 102
Norton Shores, MI 49441-6561

Mailing address

755 Seminole Rd Ste 102
Norton Shores, MI 49441-6561
Phone (231) 780-1100

National Provider Directory

National Provider Directory

Locations

755 Seminole Rd
Ste 102
Norton Shores, MI 49441
Phone (231) 780-1100

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1013591908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SEMINOLE RD STE 102",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494416561",
            "telephone_number": "231-780-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SEMINOLE RD STE 102",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494416561",
            "telephone_number": "231-780-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL DENTISTRY OF NORTON SHORES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "989-313-1843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.