NPIMap

Organization Active NPI

Heritage Comfort Dental

  • General Practice Dentistry
  • Flint, MI
National Provider Identifier
1487068508
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020598 Issued in MI
Legal business name
HERITAGE COMFORT DENTAL
Practice address
5263 Richfield Rd
Flint, MI 48506-2110
Phone
(810) 736-1500
Fax
(810) 736-1501
NPI assigned
Jun 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Authorized official

Name
Ms. Katina Jackson
Title
Office Manager
Phone
(810) 736-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901020598 MI Primary

Addresses

Primary practice location

5263 Richfield Rd
Flint, MI 48506-2110

Mailing address

5263 Richfield Rd
Flint, MI 48506-2110
Phone (810) 736-1500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1487068508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5263 RICHFIELD RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485062110",
            "telephone_number": "810-736-1500",
            "fax_number": "810-736-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5263 RICHFIELD RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485062110",
            "telephone_number": "810-736-1500",
            "fax_number": "810-736-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE COMFORT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KATINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-736-1500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020598",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 17, 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.