NPIMap

Organization Active NPI

Mid-Michigan District Health Department

  • Public Health Dentistry
  • Stanton, MI
National Provider Identifier
1376859173
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
Legal business name
MID-MICHIGAN DISTRICT HEALTH DEPARTMENT
Practice address
615 N State St
Stanton, MI 48888-9702
Phone
(989) 831-5237
Fax
(989) 831-3666
NPI assigned
Aug 31, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Ms. Melissa Selby
Title
Director of Administrative Services
Phone
(989) 831-3641

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223D0001X Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X

Addresses

Primary practice location

615 N State St
Stanton, MI 48888-9702

Mailing address

615 N State St
Stanton, MI 48888-9702
Phone (989) 831-5237

Other identifiers 1

IdentifierTypeStateIssuer
2901018840OtherMIDENTAL

National Provider Directory

National Provider Directory
Tax ID family
Mid Michigan District Health Department3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

615 N State St
Ste 1
Stanton, MI 48888
Phone (989) 831-5237

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1376859173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N STATE ST",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889702",
            "telephone_number": "989-831-5237",
            "fax_number": "989-831-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N STATE ST",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889702",
            "telephone_number": "989-831-5237",
            "fax_number": "989-831-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MICHIGAN DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "SELBY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "989-831-3641",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "2901018840",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.