NPIMap

Organization Active NPI

Deerhaven Family Dentistry, P.L.C.

  • General Practice Dentistry
  • Traverse City, MI
National Provider Identifier
1396878039
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14121 Issued in MI
Legal business name
DEERHAVEN FAMILY DENTISTRY, P.L.C.
Practice address
5217 N Royal Dr
Traverse City, MI 49684-6985
Phone
(231) 929-3606
Fax
(231) 929-0610
NPI assigned
Mar 13, 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
Dr. Steven J NiergarthNPI 1730152158
Title
Owner
Phone
(231) 929-3606

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14121 MI Primary

Addresses

Primary practice location

5217 N Royal Dr
Traverse City, MI 49684-6985

Mailing address

5217 N Royal Dr
Traverse City, MI 49684-6985
Phone (231) 929-3606

National Provider Directory

National Provider Directory

Locations

5217 N Royal Dr
Traverse City, MI 49684
Phone (231) 929-3606

Practitioners & affiliated clinicians

Practitioners 4

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": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396878039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5217 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846985",
            "telephone_number": "231-929-3606",
            "fax_number": "231-929-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5217 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846985",
            "telephone_number": "231-929-3606",
            "fax_number": "231-929-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERHAVEN FAMILY DENTISTRY, P.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIERGARTH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-929-3606",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "14121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, 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.