East Bay Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

EAST BAY FAMILY DENTISTRY

Practice address

862 Munson Ave
Traverse City, MI 49686-3602

Phone

(231) 946-4443

Fax

(231) 932-2260

NPI assigned

Aug 3, 2022

Organization subpart

No

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

Authorized official

Name

Constance Rae Kuhlman

Title

Manager

Phone

(231) 946-4443

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jan A Manning Other name

Locations

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1063149730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863602",
            "telephone_number": "231-946-4443",
            "fax_number": "231-932-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863602",
            "telephone_number": "231-946-4443",
            "fax_number": "231-932-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "KUHLMAN",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "231-946-4443"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Jan A Manning",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Samantha Lin Dzierzyc, PHARMD
• E. a. Austin DO PC
• Earlene Blevins, Ma, LPC
• Earthenwell Therapeutic Massage
• East Bay Charter Township
• East Bay Psychology, PC
• Keith W Eaton, M.D.
• Sarah J Eberhard, CRNA
• Alicia Morgan Eby, MD
• Daniel Lea Ecclestone

• Dental Clinic/Center in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.