NPIMap

Organization Active NPI

Donna L Rick DDS PC

  • Dental Clinic/Center
  • Fruitport, MI
National Provider Identifier
1427675396
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DONNA L RICK DDS PC
Practice address
40 E Beech St
Fruitport, MI 49415-9210
Phone
(231) 865-6141
Fax
(231) 865-6198
NPI assigned
Jun 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Authorized official

Name
Dr. Donna L Rick, DDSNPI 1699889329
Title
President
Phone
(231) 865-6141

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

40 E Beech St
Fruitport, MI 49415-9210

Mailing address

40 E Beech St
Fruitport, MI 49415-9210

Other identifiers 1

IdentifierTypeStateIssuer
2587410MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Server

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1427675396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E BEECH ST",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494159210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 E BEECH ST",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494159210",
            "telephone_number": "231-865-6141",
            "fax_number": "231-865-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA L RICK DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "RICK",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-865-6141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2587410",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Server",
            "affiliation": "N",
            "address_1": "40 E Beech St",
            "city": "Fruitport",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494159210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fruitport, MI

Sources for this page

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