NPIMap

Organization Active NPI

Cbmi2 PLLC

  • Pediatric Dentistry
  • Portage, MI
National Provider Identifier
1205693181
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CBMI2 PLLC
Practice address
3020 Old Centre Rd
Portage, MI 49024-4883
Phone
(269) 323-8016
NPI assigned
Mar 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Carol Guevara
Title
Insurance Coordinator
Phone
(616) 264-4709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

3020 Old Centre Rd
Portage, MI 49024-4883

Mailing address

3020 Old Centre Rd
Portage, MI 49024-4883
Phone (269) 323-8016

Other names 1

  • Portage Pediatric Dentistry PLC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1205693181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 OLD CENTRE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244883",
            "telephone_number": "269-323-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 OLD CENTRE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244883",
            "telephone_number": "269-323-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CBMI2 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "GUEVARA",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "616-264-4709"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portage Pediatric Dentistry PLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.