Active NPI
Herbert Paul Negendank, DDS
- Dentist
- Jackson, MI
National Provider Identifier
1366748741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12830
- Practice address
- 1811 E Ganson St
Jackson, MI 49202-3629 - Phone
- (517) 781-4728
- NPI assigned
- Feb 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12830 | MI | Primary |
Addresses
Primary practice location
1811 E Ganson St
Jackson, MI 49202-3629
Mailing address
1811 E Ganson St
Jackson, MI 49202-3629
Phone (517) 781-4728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12830 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1366748741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 E GANSON ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492023629",
"telephone_number": "517-781-4728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1811 E GANSON ST",
"city": "JACKSON",
"state": "MI",
"postal_code": "492023629",
"telephone_number": "517-781-4728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEGENDANK",
"first_name": "HERBERT",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-02",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "12830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.