NPIMap

Organization Active NPI

Northern Quality Dental

  • General Practice Dentistry
  • Cadillac, MI
National Provider Identifier
1144457672
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29010-19403 Issued in MI
Legal business name
NORTHERN QUALITY DENTAL
Practice address
504 Haynes St
Cadillac, MI 49601-1809
Phone
(231) 775-6531
Fax
(231) 775-6431
NPI assigned
Jun 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Authorized official

Name
Dr. Benjamin Jarvis Seymour, D.D.S.NPI 1003981002
Title
Dentist
Phone
(231) 775-6531

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 29010-19403 MI Primary

Addresses

Primary practice location

504 Haynes St
Cadillac, MI 49601-1809

Mailing address

504 Haynes St
Cadillac, MI 49601-1809
Phone (231) 775-6531

Other identifiers 10

IdentifierTypeStateIssuer
1883238OtherMIUNITED CONCORDIA
4919510MedicaidMI
D194030OtherMIBCBS
4918174MedicaidMI
4919485MedicaidMI
1883242OtherMIUNITED CONCORDIA
4918183MedicaidMI
4919500MedicaidMI
4919494MedicaidMI
D194040OtherMIBCBS

National Provider Directory

National Provider Directory

Locations

504 Haynes St
Cadillac, MI 49601
Phone (231) 775-6531

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": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1144457672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 HAYNES ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011809",
            "telephone_number": "231-775-6531",
            "fax_number": "231-775-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 HAYNES ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496011809",
            "telephone_number": "231-775-6531",
            "fax_number": "231-775-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN QUALITY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "SEYMOUR",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "JARVIS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "231-775-6531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "29010-19403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1883238",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4919510",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "D194030",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4918174",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4919485",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1883242",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4918183",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4919500",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4919494",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "D194040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.