Daniel S Maudlin DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10702 Issued in MI

Legal business name

DANIEL S MAUDLIN DDS PC

Practice address

3060 W Centre Ave
Portage, MI 49024-4825

Phone

(269) 327-4473

Fax

(269) 327-1174

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Sydney Maudlin, D.D.S

Title

General Dentist

Phone

(269) 327-4473

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1407070535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244825",
            "telephone_number": "269-327-4473",
            "fax_number": "269-327-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL S MAUDLIN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "MAUDLIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "SYDNEY",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "269-327-4473",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "10702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Portage, MI
• Providers in Portage, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.