Individual provider Active NPI

Andrew Charles Tarkington, D.D.S.

  • General Practice Dentistry
  • Alpena, MI
National Provider Identifier
1245448331
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12161 Issued in MI
Practice address
215 S Ripley Blvd
Alpena, MI 49707-4003
Phone
(989) 354-8340
NPI assigned
May 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12161 MI Primary

Addresses

Primary practice location

215 S Ripley Blvd
Alpena, MI 49707-4003

Mailing address

215 S Ripley Blvd
Alpena, MI 49707-4003
Phone (989) 354-8340

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161205001087 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911287180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12161MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alex a Tarkington DMD, PLLC PastSince Jan 4, 2026 Accepting new patients
Andrew C. Tarkington D.D.S. ,P.C. General Practice PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245448331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S RIPLEY BLVD",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497074003",
            "telephone_number": "989-354-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S RIPLEY BLVD",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497074003",
            "telephone_number": "989-354-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARKINGTON",
        "first_name": "ANDREW",
        "middle_name": "CHARLES",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

Verify at the official NPI Registry.