Main Street Dentistry, PC

Primary specialty

DentistTaxonomy code 122300000X

License

2901019511 Issued in MI

Legal business name

MAIN STREET DENTISTRY, PC

Practice address

210 S Main St
Yale, MI 48097-3319

Phone

(810) 387-4746

NPI assigned

May 14, 2012

Last updated

Aug 3, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keyna Lee Behnan, DDSNPI 1548304504

Title

President

Phone

(810) 387-4746

Specialties & licenses 2

Addresses

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.

• Keyna Lee Behnan, D.D.S

  • Dentist
  • Yale, MI
  • NPI 1548304504
  Authorized official Same address or phone

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1316206113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "YALE",
            "state": "MI",
            "postal_code": "480973319",
            "telephone_number": "810-387-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S MAIN ST",
            "city": "YALE",
            "state": "MI",
            "postal_code": "480973319",
            "telephone_number": "810-387-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-14",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "BEHNAN",
        "authorized_official_first_name": "KEYNA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-387-4746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "2901019511",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Kocis
• Tracy Lynn Krause, DPT
• Lincoln RX of Yale LLC (Sheldon Pharmacy)
• Crystal June Lukasik, BS, PT, DPT
• Matthew Richard Luttrell, P.A.-C
• Jennifer Marchetti
• Mary L. Vinckier, D.D.S., P.C.
• Marissa McCann
• Medilodge of Yale Inc (Medilodge of Yale)
• Alison Pemberton, PT

• Dentist in Yale, MI
• Providers in Yale, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.