NPIMap

Organization Active NPI

Bellairefamily & Cosmetic Dentistry, PC

  • General Practice Dentistry
  • Bellaire, MI
National Provider Identifier
1356554596
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BELLAIREFAMILY & COSMETIC DENTISTRY, PC
Practice address
4631 S M 88 Hwy
Bellaire, MI 49615-9111
Phone
(231) 533-8712
Fax
(231) 533-4142
NPI assigned
May 7, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lisa Rathke
Title
Office Manager
Phone
(231) 533-8712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

4631 S M 88 Hwy
Bellaire, MI 49615-9111

Mailing address

4631 S M 88 Hwy
Bellaire, MI 49615-9111
Phone (231) 533-8712

National Provider Directory

National Provider Directory

Locations

4631 S M 88 Hwy
Bellaire, MI 49615
Phone (231) 533-8712

Practitioners & affiliated clinicians

Practitioners 3

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356554596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 S M 88 HWY",
            "city": "BELLAIRE",
            "state": "MI",
            "postal_code": "496159111",
            "telephone_number": "231-533-8712",
            "fax_number": "231-533-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 S M 88 HWY",
            "city": "BELLAIRE",
            "state": "MI",
            "postal_code": "496159111",
            "telephone_number": "231-533-8712",
            "fax_number": "231-533-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLAIREFAMILY & COSMETIC DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RATHKE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "231-533-8712"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.