NPIMap

Organization Active NPI

Dental Dreams PLLC

  • General Practice Dentistry
  • Muskegon, MI
National Provider Identifier
1336407592
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL DREAMS PLLC
Practice address
1725 E Sherman Blvd
Muskegon, MI 49444-1862
Phone
(810) 789-5880
NPI assigned
Apr 25, 2012
Last updated
Sep 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Authorized official

Name
Peter Stathakis
Title
Cfo
Phone
(312) 274-0308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1725 E Sherman Blvd
Muskegon, MI 49444-1862

Mailing address

1725 E Sherman Blvd
Muskegon, MI 49444-1862

National Provider Directory

National Provider Directory
Tax ID family
Dental Dreams PLLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1725 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 237-2922

Practitioners & affiliated clinicians

Practitioners 2

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": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1336407592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441862",
            "telephone_number": "810-789-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL DREAMS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "STATHAKIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-274-0308"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.