Dentistry Etc

Primary specialty

DentistTaxonomy code 122300000X

License

12818 Issued in MI

Legal business name

DENTISTRY ETC

Practice address

4025 E Hill Rd
Grand Blanc, MI 48439-7942

Phone

(810) 695-4300

Fax

(810) 695-2309

NPI assigned

Nov 20, 2008

Organization subpart

No

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

Authorized official

Name

Jill Leach

Title

Office Manager

Phone

(810) 695-4300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1447405261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 E HILL RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397942",
            "telephone_number": "810-695-4300",
            "fax_number": "810-695-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 E HILL RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397942",
            "telephone_number": "810-695-4300",
            "fax_number": "810-695-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY ETC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-695-4300"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "12818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Randall Denning, D.C.
• Dental Care Team P C
• Dental Care Team- Fenton Road
• Dental Care Team- Hill Road
• Dental Group of America Specialty Center P.C.
• Khyati Desai
• Roberto Desarden, MD
• Desgranges Psychiatric Center
• Louise Desgranges, MD
• Renae Deshaw, OTRL

• Dentist in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.