NPIMap

Organization Active NPI

Max and Mandy Dental, PC

Doing business as Maize and Blue Dental

  • Dental Clinic/Center
  • Ypsilanti, MI
National Provider Identifier
1558975672
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MAX AND MANDY DENTAL, PC
Doing business as
Maize and Blue Dental
Practice address
2792 Packard Rd
Ypsilanti, MI 48197-1932
Phone
(734) 434-6170
Fax
(734) 514-4584
NPI assigned
Sep 4, 2020
Last updated
Sep 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Authorized official

Name
Dr. John Duncan McLaren, DDSNPI 1972617215
Title
President
Phone
(734) 645-6548

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
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

2792 Packard Rd
Ypsilanti, MI 48197-1932

Mailing address

2792 Packard Rd
Ypsilanti, MI 48197-1932
Phone (734) 434-6170

Other names 1

  • Maize and Blue Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2792 Packard Rd
Ypsilanti, MI 48197
Phone (734) 434-6170

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1558975672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2792 PACKARD RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971932",
            "telephone_number": "734-434-6170",
            "fax_number": "734-514-4584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2792 PACKARD RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971932",
            "telephone_number": "734-434-6170",
            "fax_number": "734-514-4584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAX AND MANDY DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "MCLAREN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DUNCAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-645-6548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maize and Blue Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.