NPIMap

Organization Active NPI

Mid-Michigan Dental Associates PLC Gladwin

  • Dentist
  • Gladwin, MI
National Provider Identifier
1104947878
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
015374 Issued in MI
Legal business name
MID-MICHIGAN DENTAL ASSOCIATES PLC GLADWIN
Practice address
200 W Cedar Ave
Gladwin, MI 48624-2020
Phone
(989) 426-6341
Fax
(989) 426-6411
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Laura Lee Coney, R.D.H.
Title
Office Manager
Phone
(989) 426-6341

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 015374 MI Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 019185 MI

Addresses

Primary practice location

200 W Cedar Ave
Gladwin, MI 48624-2020

Mailing address

200 W Cedar Ave
Gladwin, MI 48624-2020
Phone (989) 426-6341

National Provider Directory

National Provider Directory

Locations

200 W Cedar Ave
Gladwin, MI 48624
Phone (989) 426-6341

Practitioners & affiliated clinicians

Practitioners 2

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": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1104947878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486242020",
            "telephone_number": "989-426-6341",
            "fax_number": "989-426-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486242020",
            "telephone_number": "989-426-6341",
            "fax_number": "989-426-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MICHIGAN DENTAL ASSOCIATES PLC GLADWIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "CONEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-426-6341",
        "authorized_official_credential": "R.D.H."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "015374",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "019185",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladwin, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.