NPIMap

Organization Active NPI

Katelyn M Nieten DDS PLC

  • Dental Clinic/Center
  • Mount Pleasant, MI
National Provider Identifier
1295464451
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KATELYN M NIETEN DDS PLC
Practice address
611 E Broadway St
Mount Pleasant, MI 48858-2793
Phone
(989) 773-5299
NPI assigned
Jun 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Authorized official

Name
Dr. Katelyn Nieten, DDSNPI 1184062739
Title
Owner
Phone
(989) 763-6094

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

611 E Broadway St
Mount Pleasant, MI 48858-2793

Mailing address

611 E Broadway St
Mount Pleasant, MI 48858-2793

Other names 1

  • Broadway Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

611 E Broadway St
Mt Pleasant, MI 48858
Phone (989) 773-5299

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1654387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1295464451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E BROADWAY ST",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E BROADWAY ST",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582793",
            "telephone_number": "989-773-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATELYN M NIETEN DDS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-05",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "NIETEN",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-763-6094",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.