Northern Michigan Family Dentistry PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16080 Issued in MI

Legal business name

NORTHERN MICHIGAN FAMILY DENTISTRY PLLC

Practice address

1507 S Otsego Ave Ste a
Gaylord, MI 49735-9524

Phone

(989) 732-4199

Fax

(989) 731-6762

NPI assigned

Apr 2, 2008

Organization subpart

No

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

Authorized official

Name

Nicole Koenig

Title

Office Manager

Phone

(989) 732-4199

Specialties & licenses 1

Addresses

Other names 1

• Gaylord Family Dentistry Doing business as

Tax ID family

Northern Michigan Family Dentistry PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northern Michigan Family Dentistry PLLC

  • Dentist
  • Cheboygan, MI
  • NPI 1437428364
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Northern Michigan Family Dentistry PLLC

  • Dentist
  • Cheboygan, MI
  • NPI 1437428364
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William P Koenig, DDS

  • Dentist
  • Cheboygan, MI
  • NPI 1235224411
  NPD (past)

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1215100987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1725",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497345725",
            "telephone_number": "989-732-4199",
            "fax_number": "989-731-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S OTSEGO AVE STE A",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359524",
            "telephone_number": "989-732-4199",
            "fax_number": "989-731-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MICHIGAN FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-732-4199"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gaylord Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• North Shores Center, LLC
• Northern Family Intervention Services, Inc.
• Northern Management Services LTD
• Northern Management Services, LTD.
• Northern Michigan Chiropractic Center, PLC
• Northern Michigan Home Care, Inc
• Northern Michigan Re-Integration Services, Inc.
• Northern Michigan Substance Abuse Services, Inc.
• Northsport Physical Therapy & Rehabilitation P C
• Northwest Michigan Community Health Agency

• General Practice Dentistry in Gaylord, MI
• Providers in Gaylord, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.