Patient Dentistry,P.C.

Key facts

NPI

1639295652

Entity type

Organization (NPI type 2)

Primary specialty

Dentist 122300000X

License

2901016419 (MI)

Legal business name

PATIENT DENTISTRY,P.C.

Practice address

113 South Kalamazoo St.
White Pigeon, MI 49099

Phone

(269) 483-9621

Fax

(269) 483-2569

NPI assigned

Mar 21, 2007

Organization subpart

No

Authorized official

Name

Dr. Patrick William Goodman, D.D.S NPI 1134259047

Title

President

Phone

(269) 483-9621

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

• Patrick William Goodman, DDS Dentist · White Pigeon, MI · NPI 1134259047
  NPD (past) Authorized official DENTIST

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639295652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 SOUTH KALAMAZOO ST.",
            "address_2": "P.O. BOX 695",
            "city": "WHITE PIGEON",
            "state": "MI",
            "postal_code": "49099",
            "telephone_number": "269-483-9621",
            "fax_number": "269-483-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 SOUTH KALAMAZOO ST.",
            "city": "WHITE PIGEON",
            "state": "MI",
            "postal_code": "49099",
            "telephone_number": "269-483-9621",
            "fax_number": "269-483-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENT DENTISTRY,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-483-9621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1134259047",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST LICENSE",
            "identifier": "2901016419",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in White Pigeon, MI · Dentist in Michigan