NPIMap

Organization Active NPI

China Township Family Dentistry

  • Dentist
  • China Township, MI
National Provider Identifier
1417091141
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901016966 Issued in MI
Legal business name
CHINA TOWNSHIP FAMILY DENTISTRY
Practice address
5013 St Clair Hwy
China Township, MI 48054
Phone
(810) 329-6655
Fax
(810) 329-6687
NPI assigned
Feb 16, 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. Gordon Carl Charlton, DDSNPI 1215075064
Title
President
Phone
(810) 329-6655

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)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901016966 MI Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901016483 MI

Addresses

Primary practice location

5013 St Clair Hwy
China Township, MI 48054

Mailing address

5013 St Clair Hwy
China Township, MI 48054
Phone (810) 329-6655

National Provider Directory

National Provider Directory

Locations

5013 Saint Clair Hwy
East China, MI 48054
Phone (810) 329-6655

Practitioners & affiliated clinicians

Practitioners 2

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": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417091141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5013 ST CLAIR HWY",
            "city": "CHINA TOWNSHIP",
            "state": "MI",
            "postal_code": "48054",
            "telephone_number": "810-329-6655",
            "fax_number": "810-329-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5013 ST CLAIR HWY",
            "city": "CHINA TOWNSHIP",
            "state": "MI",
            "postal_code": "48054",
            "telephone_number": "810-329-6655",
            "fax_number": "810-329-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINA TOWNSHIP FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHARLTON",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-329-6655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016966",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in China Township, 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.