Blythe a O'Donnell, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

18268 Issued in MI

Legal business name

BLYTHE A O'DONNELL, PLLC

Practice address

812 Cypress St
Manistee, MI 49660-2110

Phone

(231) 723-6512

Fax

(231) 723-0000

NPI assigned

Dec 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Blythe A O'Donnell, DDS

Title

Dentist

Phone

(231) 723-6512

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1255846754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 CYPRESS ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496602110",
            "telephone_number": "231-723-6512",
            "fax_number": "231-723-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 CYPRESS ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496602110",
            "telephone_number": "231-723-6512",
            "fax_number": "231-723-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLYTHE A O'DONNELL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "BLYTHE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "231-723-6512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "18268",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "11462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Richard Artin Bobian, DDS
• Fritz R Boehm, D.C.
• Heidi L Boehm, D.C.
• Stacey Bonecutter, FNP
• Kenneth Albert Borenitsch, D.O.

• Dental Clinic/Center in Manistee, MI
• Providers in Manistee, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.