Kristy Fornetti, D.D.S
Individual provider Active NPI General Practice Dentistry · Norway, MI
NPI 1104153634 · NPPES record last updated Nov 4, 2009
Key facts
- NPI
- 1104153634
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- L1373793 (MI)
- Practice address
- 800 South Case Street
Norway, MI 49870-0069 - Phone
- (906) 563-8010
- Fax
- (906) 563-5862
- NPI assigned
- Nov 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160224000052 | MI | Order and Referring Only - Dentist |
7315242757 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1373793 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norway Dental PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | L1373793 | MI | Yes |
Addresses
Primary practice location
800 South Case Street
Norway, MI 49870-0069
Mailing address
PO Box 69
Norway, MI 49870-0069
Phone (906) 563-8010
Other providers in Norway, MI
- Dickinson County Healthcare System
- Dickinson County Healthcare System
- Maria Violet Duby
- Richard Lee Fila
- Angela Marian Fornetti
- Foundations Health & Physical Medicine
- Joan V Freiberg
- Jerry Lee Gilbert
- Christy Graham
- Paul Nelson Hayes
All providers in Norway, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.