NPIMap

Organization Active NPI

Dawn Ag Kulongowski, DDS, PC

Doing business as Creative Smiles Dental Group

  • General Practice Dentistry
  • Holly, MI
National Provider Identifier
1649664269
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018388 Issued in MI
Legal business name
DAWN AG KULONGOWSKI, DDS, PC
Doing business as
Creative Smiles Dental Group
Practice address
124 N Saginaw St
Suite C
Holly, MI 48442-1687
Phone
(248) 634-1976
Fax
(248) 634-2414
NPI assigned
Mar 20, 2015
Last updated
Mar 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Authorized official

Name
Chris Wagner
Title
Office Manager
Phone
(248) 634-1976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901018388 MI Primary

Addresses

Primary practice location

124 N Saginaw St
Suite C
Holly, MI 48442-1687

Mailing address

124 N Saginaw St
Suite C
Holly, MI 48442-1687
Phone (248) 634-1976

Other names 1

  • Creative Smiles Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

124 N Saginaw St
Ste C
Holly, MI 48442
Phone (248) 634-1976

Practitioners & affiliated clinicians

Practitioners 3

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": "1426809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1649664269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 N SAGINAW ST",
            "address_2": "SUITE C",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484421687",
            "telephone_number": "248-634-1976",
            "fax_number": "248-634-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N SAGINAW ST",
            "address_2": "SUITE C",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484421687",
            "telephone_number": "248-634-1976",
            "fax_number": "248-634-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAWN AG KULONGOWSKI, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-20",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-634-1976"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Smiles Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holly, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.