Great Lakes Family Dental Group-St. Joseph

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREAT LAKES FAMILY DENTAL GROUP-ST. JOSEPH

Practice address

2525 S Cleveland Ave
Saint Joseph, MI 49085-2649

Phone

(810) 625-2860

NPI assigned

Jul 13, 2016

Last updated

Jul 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia J. Hart

Title

Corporate Manager

Phone

(810) 625-2860

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468368000000",
    "number": "1598117616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S CLEVELAND AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 S CLEVELAND AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852649",
            "telephone_number": "810-625-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES FAMILY DENTAL GROUP-ST. JOSEPH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CORPORATE MANAGER",
        "authorized_official_telephone_number": "810-625-2860",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Marie Grabemeyer-Layman, M.D.
• Tamara L Grady, PA
• Albert Grashuis, LPC
• Alison Graves
• Great Lakes Eye Care PC (Great Lakes Eye Care)
• Great Lakes Gastroenterology PLLC
• Great Lakes Heart & Vascular Institute, P.C.
• Great Lakes Sports Medicine and Concussion Clinic
• Great Lakes Surgery Center LLC
• Mark H Greenberg, MD

• Dentist in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; 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.