Andrew James Ekdahl, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

IN PROCESS Issued in MI

Practice address

271 E M35
Gwinn, MI 49841-9003

Phone

(906) 346-6349

NPI assigned

May 10, 2012

Last updated

May 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peninsula Family Dentistry, PC

  • Dentist
  • Marquette, MI
  • NPI 1093315202
  NPD Authorized official
• Gwendolyn Buck DDS PLLC

  dba Northern Trails Dental Care

  • General Practice Dentistry
  • Gwinn, MI
  • NPI 1346500279
  NPD (past)
• Gwendolyn Buck DDS PLLC

  • Dental Clinic/Center
  • Gwinn, MI
  • NPI 1457904229
  NPD (past)

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1184983249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 KEMP ST",
            "city": "LANSE",
            "state": "MI",
            "postal_code": "499461439",
            "telephone_number": "906-201-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 E M35",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498419003",
            "telephone_number": "906-346-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKDAHL",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "IN PROCESS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisenia Collazo, DMD
• Theodore W Collins, D.O.
• Ashley E Croasdell, FNP
• Sandra Croasdell, FNP-BC
• Ericka Marie Distefano, FNP, ACUPUNCTURIST
• Collene Nicole Froberg, D.C.
• Garrett H Green, LPC
• Gwendolyn Buck DDS PLLC (Northern Trails Dental Care)
• Gwendolyn Buck DDS PLLC
• Linda Helen Hammond

• Dentist in Gwinn, MI
• Providers in Gwinn, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.