Corey Lee Allen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901019185 Issued in MI

Practice address

200 W Cedar Ave
Gladwin, MI 48624-2020

Phone

(989) 426-6341

Fax

(989) 426-6411

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mid-Michigan Dental Associates PLC Gladwin

  • Dentist
  • Gladwin, MI
  • NPI 1104947878
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053400267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W. CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "48624",
            "telephone_number": "989-426-6341",
            "fax_number": "989-426-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486242020",
            "telephone_number": "989-426-6341",
            "fax_number": "989-426-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "COREY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4867549",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aimee Lucille Abbott
• Accuquest Hearing Center, LLC
• Aging Responsibly, Inc
• Deborah Faye Aldrich
• Rylie Alward, PA
• Evangeline A Ancheta, M.D.
• Atrium Gladwin LLC (Gladwin Nursing and Rehabilitation Community)
• Kelly Jo Avila
• Beau Richard Bailer

• General Practice Dentistry in Gladwin, MI
• Providers in Gladwin, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.