Daryle John Mahnke, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901019315 Issued in MI

Practice address

203 E Midland St
Bay City, MI 48706-4631

Phone

(989) 684-0873

Fax

(989) 684-4585

NPI assigned

Apr 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264204800000",
    "number": "1275654022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 BEYERLEIN ST",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E MIDLAND ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487064631",
            "telephone_number": "989-684-0873",
            "fax_number": "989-684-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHNKE",
        "first_name": "DARYLE",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2010-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lalit Mahajan, RPH
• Jenna M Mahar
• Jordyn Ann Mahar
• Jennah Marie Mahlon
• Rehan Mahmud, MD
• Morgan Emily Maida
• Maillette Chiropractic PC
• Eric John Maillette, DC
• Rachel Marie Maillette
• Justin Leray Main, MSN, APRN, FNP-BC

• General Practice Dentistry in Bay City, MI
• Providers in Bay City, 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 Jan 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.