Organization Active NPI

Convenient Family Dentistry, P.C.

  • General Practice Dentistry
  • Burton, MI
National Provider Identifier
1174675698
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901009015 Issued in MI
Legal business name
CONVENIENT FAMILY DENTISTRY, P.C.
Practice address
2414 S Center Rd
Burton, MI 48519-1152
Phone
(810) 744-3388
Fax
(810) 744-4080
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Maryanne Rykulski
Title
General Manager
Phone
(810) 744-3388

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901009015 MI Primary

Addresses

Primary practice location

2414 S Center Rd
Burton, MI 48519-1152

Mailing address

2414 S Center Rd
Burton, MI 48519-1152
Phone (810) 744-3388

National Provider Directory

National Provider Directory

Locations

2414 S Center Rd
Burton, MI 48519
Phone (810) 744-3388

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174675698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191152",
            "telephone_number": "810-744-3388",
            "fax_number": "810-744-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191152",
            "telephone_number": "810-744-3388",
            "fax_number": "810-744-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYKULSKI",
        "authorized_official_first_name": "MARYANNE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "810-744-3388",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901009015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

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