Organization Active NPI

Copper Country Family Dentistry P.C.

  • General Practice Dentistry
  • Houghton, MI
National Provider Identifier
1063640480
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020042 Issued in MI
Legal business name
COPPER COUNTRY FAMILY DENTISTRY P.C.
Practice address
19225 Calverley St
Houghton, MI 49931-2809
Phone
(906) 482-0808
Fax
(906) 482-0808
NPI assigned
Jun 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Authorized official

Name
Dr. Robert Douglas Chalgren Jr., D.D.S.
Title
Dentist
Phone
(906) 482-0808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901020042 MI Primary

Addresses

Primary practice location

19225 Calverley St
Houghton, MI 49931-2809

Mailing address

19225 Calverley St
Houghton, MI 49931-2809
Phone (906) 482-0808

National Provider Directory

National Provider Directory

Locations

19225 Calverley St
Houghton, MI 49931
Phone (906) 482-0808

Practitioners & affiliated clinicians

Practitioners 1

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": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1063640480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19225 CALVERLEY ST",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312809",
            "telephone_number": "906-482-0808",
            "fax_number": "906-482-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19225 CALVERLEY ST",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312809",
            "telephone_number": "906-482-0808",
            "fax_number": "906-482-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER COUNTRY FAMILY DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "CHALGREN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "906-482-0808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houghton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.