NPIMap

Organization Active NPI

Yax & Stec Dental Associates, PLLC

  • General Practice Dentistry
  • New Haven, MI
National Provider Identifier
1265628291
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901011882 Issued in MI
Legal business name
YAX & STEC DENTAL ASSOCIATES, PLLC
Practice address
58144 Gratiot Ave
Suite 316
New Haven, MI 48048
Phone
(586) 749-3333
NPI assigned
Sep 24, 2007
Last updated
Nov 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Susan Ann Ventura, MANAGER
Title
Office Manager
Phone
(586) 749-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901011882 MI Primary

Addresses

Primary practice location

58144 Gratiot Ave
Suite 316
New Haven, MI 48048

Mailing address

58144 Gratiot Ave Ste 316
P.O. Box 480336
New Haven, MI 48048
Phone (586) 749-3333

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1265628291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58144 GRATIOT AVE STE 316",
            "address_2": "P.O. BOX 480336",
            "city": "NEW HAVEN",
            "state": "MI",
            "postal_code": "48048",
            "telephone_number": "586-749-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58144 GRATIOT AVE",
            "address_2": "SUITE 316",
            "city": "NEW HAVEN",
            "state": "MI",
            "postal_code": "48048",
            "telephone_number": "586-749-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAX & STEC DENTAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "VENTURA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-749-3333",
        "authorized_official_credential": "MANAGER"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901011882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.