NPIMap

Organization Active NPI

Peninsula Family Dentistry, PC

  • Dentist
  • Marquette, MI
National Provider Identifier
1093315202
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PENINSULA FAMILY DENTISTRY, PC
Practice address
3210 US 41 W
Marquette, MI 49855-9483
Phone
(906) 226-9935
NPI assigned
Oct 27, 2020
Last updated
Oct 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Authorized official

Name
Dr. Andrew Ekdahl, DDSNPI 1184983249
Title
Owner Dentist
Phone
(906) 226-9935

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
Dentist 122300000X NU Primary

Addresses

Primary practice location

3210 US 41 W
Marquette, MI 49855-9483

Mailing address

3210 US 41 W
Marquette, MI 49855-9483
Phone (906) 226-9935

Other practice location 1

100 Croix St
Negaunee, MI 49866-1104
Phone (906) 475-9958

National Provider Directory

National Provider Directory

Locations

3210 US Highway 41 W
Marquette, MI 49855
Phone (906) 226-9935

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1093315202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 US 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559483",
            "telephone_number": "906-226-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 US 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559483",
            "telephone_number": "906-226-9935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Croix St",
            "address_purpose": "LOCATION",
            "city": "Negaunee",
            "state": "MI",
            "postal_code": "498661104",
            "country_code": "US",
            "telephone_number": "906-475-9958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PENINSULA FAMILY DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "EKDAHL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "906-226-9935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.