Maze Family Dentistry, PC

Primary specialty

DentistTaxonomy code 122300000X

License

12009364 Issued in IN

Legal business name

MAZE FAMILY DENTISTRY, PC

Practice address

601 Mill St
Crawfordsvlle, IN 47933-3440

Phone

(765) 362-5220

Fax

(765) 362-6393

NPI assigned

Sep 21, 2014

Organization subpart

No

Name

Dr. Michael Maze, DDSNPI 1538257332

Title

President

Phone

(765) 362-5220

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Kenneth Maze, DDS

  • General Practice Dentistry
  • Crawfordsville, IN
  • NPI 1538257332
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 21, 2014.

{
    "created_epoch": "1411257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411257600000",
    "number": "1477955458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MILL ST",
            "city": "CRAWFORDSVLLE",
            "state": "IN",
            "postal_code": "479333440",
            "telephone_number": "765-362-5220",
            "fax_number": "765-362-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MILL ST",
            "city": "CRAWFORDSVLLE",
            "state": "IN",
            "postal_code": "479333440",
            "telephone_number": "765-362-5220",
            "fax_number": "765-362-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZE FAMILY DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-21",
        "last_updated": "2014-09-21",
        "status": "A",
        "authorized_official_last_name": "MAZE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-362-5220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.