NPIMap

Organization Active NPI

Dental Associates of Marquette PLLP

  • General Practice Dentistry
  • Marquette, MI
National Provider Identifier
1376787762
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
MM015901 Issued in MI
Legal business name
DENTAL ASSOCIATES OF MARQUETTE PLLP
Practice address
708 Chippewa SQ
Marquette, MI 49855-4814
Phone
(906) 228-9594
Fax
(906) 228-9196
NPI assigned
Apr 29, 2009
Last updated
Apr 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Authorized official

Name
Dr. Mark F. McGovern, DDSNPI 1649486481
Title
Partner
Phone
(906) 228-9594

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X MS19101 MI
General Practice Dentistry 1223G0001X RP010017 MI
General Practice Dentistry 1223G0001X MM015901 MI Primary

Addresses

Primary practice location

708 Chippewa SQ
Marquette, MI 49855-4814

Mailing address

708 Chippewa SQ
Marquette, MI 49855-4814
Phone (906) 228-9594

National Provider Directory

National Provider Directory

Locations

708 Chippewa Sq
Marquette, MI 49855
Phone (906) 228-9594

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1376787762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CHIPPEWA SQ",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554814",
            "telephone_number": "906-228-9594",
            "fax_number": "906-228-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CHIPPEWA SQ",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554814",
            "telephone_number": "906-228-9594",
            "fax_number": "906-228-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ASSOCIATES OF MARQUETTE PLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "MCGOVERN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "906-228-9594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "MS19101",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "RP010017",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "MM015901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.