Organization Active NPI

Clarkston Family Dental

  • General Practice Dentistry
  • Clarkston, MI
National Provider Identifier
1497946636
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17279 Issued in MI
Legal business name
CLARKSTON FAMILY DENTAL
Practice address
6778 Bluegrass Dr
Clarkston, MI 48346-1400
Phone
(248) 625-2424
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Authorized official

Name
John Foster, D.D.S.NPI 1639279151
Title
Owner
Phone
(248) 625-2424

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 17279 MI Primary

Addresses

Primary practice location

6778 Bluegrass Dr
Clarkston, MI 48346-1400

Mailing address

6778 Bluegrass Dr
Clarkston, MI 48346-1400

National Provider Directory

National Provider Directory

Locations

6778 Bluegrass Dr
Clarkston, MI 48346
Phone (248) 625-2424

Practitioners & affiliated clinicians

Practitioners 4

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": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1497946636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6778 BLUEGRASS DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6778 BLUEGRASS DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461400",
            "telephone_number": "248-625-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSTON FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-625-2424",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "17279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.