Valcor Dental Center PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901018276 Issued in MI

Legal business name

VALCOR DENTAL CENTER PC

Doing business as

Birchwood Family Dental

Practice address

4036 24TH Ave
Fort Gratiot, MI 48059-3800

Phone

(810) 385-9766

Fax

(810) 385-4161

NPI assigned

Jul 22, 2015

Organization subpart

No

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

Authorized official

Name

Celeste R Cornell-Valdes, DDSNPI 1366488330

Title

Owner

Phone

(810) 385-9766

Specialties & licenses 1

Addresses

Other names 1

• BIRCHWOOD FAMILY DENTAL Doing business as

Practitioners 1

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

• Celeste Ruhia Cornell-Valdes, DDS

  • General Practice Dentistry
  • Fort Gratiot, MI
  • NPI 1366488330
  NPD (past) Authorized official

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1528443363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593800",
            "telephone_number": "810-385-9766",
            "fax_number": "810-385-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593800",
            "telephone_number": "810-385-9766",
            "fax_number": "810-385-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALCOR DENTAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "CORNELL-VALDES",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-385-9766",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BIRCHWOOD FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Omar A Turk
• Makenzie Turner, RPH
• Chelsea Ann Urbano
• Usv Optical Inc.
• Usv Optical, Inc. (Meijer Optical)
• Shannon L Van Belle
• Christopher Dale Vanderploeg
• Lisa Vanmaele, CPNP
• Rebecca L Vargo
• Elizabeth A Varty, LPC

• General Practice Dentistry in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; 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.