Active NPI
Dentistry by Design of Jackson, PLC
- Dentist
- Jackson, MI
National Provider Identifier
1396276333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901020967
- Legal business name
- DENTISTRY BY DESIGN OF JACKSON, PLC
- Practice address
- 306 W Washington Ave Ste 205
Jackson, MI 49201-2141 - Phone
- (517) 787-5055
- Fax
- (517) 787-9346
- NPI assigned
- Mar 22, 2017
- Organization subpart
- Yes
- Parent organization
- DENTISTRY BY DESIGN OF JACKSON, PLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Andrew James Balaze, D.M.D.
- Title
- Dentist/Owner
- Phone
- (517) 787-5055
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901020967 | MI | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
306 W Washington Ave Ste 205
Jackson, MI 49201-2141
Mailing address
306 W Washington Ave Ste 205
Jackson, MI 49201-2141
Phone (517) 787-5055
National Provider Directory
National Provider Directory- Part of
- Dentistry by Design of Jackson PLC
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Jackson, MI
- NPI 1851730592
-
- Specialist
- Jackson, MI
- NPI 1811725062
-
- General Practice Dentistry
- Jackson, MI
- NPI 1376632737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490140800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1565136000000",
"number": "1396276333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 W WASHINGTON AVE STE 205",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012141",
"telephone_number": "517-787-5055",
"fax_number": "517-787-9346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 W WASHINGTON AVE STE 205",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012141",
"telephone_number": "517-787-5055",
"fax_number": "517-787-9346"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DENTISTRY BY DESIGN OF JACKSON, PLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DENTISTRY BY DESIGN OF JACKSON, PLC",
"enumeration_date": "2017-03-22",
"last_updated": "2019-08-07",
"status": "A",
"authorized_official_last_name": "BALAZE",
"authorized_official_first_name": "ANDREW",
"authorized_official_middle_name": "JAMES",
"authorized_official_title_or_position": "DENTIST/OWNER",
"authorized_official_telephone_number": "517-787-5055",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.M.D."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MI",
"license": "2901020967",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
}
],
"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 Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.