Active NPI
PGS D-Provider Dentistry PLLC
- General Practice Dentistry
- Marysville, MI
National Provider Identifier
1639791585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- PGS D-PROVIDER DENTISTRY PLLC
- Practice address
- 1616 Gratiot Blvd
Marysville, MI 48040-1181 - Phone
- (586) 727-3815
- NPI assigned
- May 14, 2020
- Organization subpart
- Yes
- Parent organization
- PGS D-PROVIDER DENTISTRY PLLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandi Barnes
- Title
- Office Manager
- Phone
- (586) 727-3815
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
1616 Gratiot Blvd
Marysville, MI 48040-1181
Mailing address
1616 Gratiot Blvd
Marysville, MI 48040-1181
Phone (586) 727-3815
National Provider Directory
National Provider Directory- Part of
- PGS D-Provider Dentistry PLLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589414400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1589414400000",
"number": "1639791585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 GRATIOT BLVD",
"city": "MARYSVILLE",
"state": "MI",
"postal_code": "480401181",
"telephone_number": "586-727-3815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 GRATIOT BLVD",
"city": "MARYSVILLE",
"state": "MI",
"postal_code": "480401181",
"telephone_number": "586-727-3815"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PGS D-PROVIDER DENTISTRY PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PGS D-PROVIDER DENTISTRY PLLC",
"enumeration_date": "2020-05-14",
"last_updated": "2020-05-14",
"certification_date": "2020-05-14",
"status": "A",
"authorized_official_last_name": "BARNES",
"authorized_official_first_name": "SANDI",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "586-727-3815"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.