NPIMap

Organization Active NPI

Mid-Michigan Pediatric Dentistry

  • Pediatric Dentistry
  • Flint, MI
National Provider Identifier
1437323904
Registry record updated Jan 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2901019960 Issued in MI
Legal business name
MID-MICHIGAN PEDIATRIC DENTISTRY
Practice address
1125 S Linden Rd
Suite 800
Flint, MI 48532-4073
Phone
(810) 733-5310
Fax
(810) 733-1216
NPI assigned
Apr 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2014

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

Authorized official

Name
Dr. John Michael Sushynski, D.D.S., M.S.NPI 1114168978
Title
Member
Phone
(810) 733-5310

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 2901019960 MI Primary

Addresses

Primary practice location

1125 S Linden Rd
Suite 800
Flint, MI 48532-4073

Mailing address

1125 S Linden Rd
Suite 800
Flint, MI 48532-4073
Phone (810) 733-5310

Other identifiers 1

IdentifierTypeStateIssuer
4060491MedicaidMI

National Provider Directory

National Provider Directory

Locations

1125 S Linden Rd
Ste 800
Flint, MI 48532
Phone (810) 733-5310

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": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388534400000",
    "number": "1437323904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 S LINDEN RD",
            "address_2": "SUITE 800",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324073",
            "telephone_number": "810-733-5310",
            "fax_number": "810-733-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S LINDEN RD",
            "address_2": "SUITE 800",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324073",
            "telephone_number": "810-733-5310",
            "fax_number": "810-733-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MICHIGAN PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2014-01-01",
        "status": "A",
        "authorized_official_last_name": "SUSHYNSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "810-733-5310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901019960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4060491",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2014; 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.