Manistique Dental Center, P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

2901016294 Issued in MI

Legal business name

MANISTIQUE DENTAL CENTER, P.C.

Practice address

115 N Lake St Lowr Level
Manistique, MI 49854-1234

Phone

(906) 341-6132

Fax

(906) 341-3054

NPI assigned

Apr 22, 2008

Organization subpart

No

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

Authorized official

Name

Gregory David Lafayette, DDSNPI 1558410902

Title

President

Phone

(906) 341-6132

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Gregory David La Fayette, DDS

  • General Practice Dentistry
  • Manistique, MI
  • NPI 1558410902
  NPD (past) Authorized official

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1093980955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N LAKE ST LOWR LEVEL",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498541234",
            "telephone_number": "906-341-6132",
            "fax_number": "906-341-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N LAKE ST LOWR LEVEL",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498541234",
            "telephone_number": "906-341-6132",
            "fax_number": "906-341-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANISTIQUE DENTAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "LAFAYETTE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-341-6132",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558410902",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jakyser Lett
• Little Ones of the Up, LLC
• Mark Alexander Madion, DDS
• Maline Family Chiropractic PLLC
• Jonathan C Maline, DC
• Manistique Pharmaceuticals Inc
• Manistique Pharmaceuticals Inc.
• Donna McDaniel-Maynard
• Austin McDonough, LLMSW
• Trisha Ann McEvers, LMSW

• All providers in Manistique, MI
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.