NPIMap

Organization Active NPI

Marlette Fam Dentistry PLLC

  • Dentist
  • Marlette, MI
National Provider Identifier
1306373824
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901014174 Issued in MI
Legal business name
MARLETTE FAM DENTISTRY PLLC
Practice address
3149 Main St
Marlette, MI 48453-1255
Phone
(989) 635-7541
Fax
(989) 635-2414
NPI assigned
May 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Gail Ann Pankratz, RN
Title
Credential Officer
Phone
(989) 269-8401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901014174 MI Primary

Addresses

Primary practice location

3149 Main St
Marlette, MI 48453-1255

Mailing address

3149 Main St
Marlette, MI 48453-1255
Phone (989) 635-7541

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1306373824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3149 MAIN ST",
            "city": "MARLETTE",
            "state": "MI",
            "postal_code": "484531255",
            "telephone_number": "989-635-7541",
            "fax_number": "989-635-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3149 MAIN ST",
            "city": "MARLETTE",
            "state": "MI",
            "postal_code": "484531255",
            "telephone_number": "989-635-7541",
            "fax_number": "989-635-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLETTE FAM DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PANKRATZ",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CREDENTIAL OFFICER",
        "authorized_official_telephone_number": "989-269-8401",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901014174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.