State Street Family Dental

Primary specialty

DentistTaxonomy code 122300000X

License

13188 Issued in MI

Legal business name

STATE STREET FAMILY DENTAL

Practice address

100 S Scott Rd
Saint Johns, MI 48879-9038

Phone

(989) 227-1858

Fax

(989) 227-2268

NPI assigned

Aug 12, 2009

Organization subpart

No

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

Authorized official

Name

Jennifer Nicole Osborne

Title

Office Manager

Phone

(989) 227-1858

Specialties & licenses 5

Addresses

Locations

Practitioners 1

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

• Dominique Rae Macphail, DDS

  • Dentist
  • Okemos, MI
  • NPI 1679197156
  NPD (past)

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250035200000",
    "number": "1669604484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S SCOTT RD",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488799038",
            "telephone_number": "989-227-1858",
            "fax_number": "989-227-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S SCOTT RD",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488799038",
            "telephone_number": "989-227-1858",
            "fax_number": "989-227-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE STREET FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-227-1858"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "13188",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "901013605",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018410",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "012271",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019279",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Johns Smiles
• St. Johns Chiropractic Clinic, Inc.
• St. Johns Counseling and Therapy Services, P.C.
• St. Johns Internal Medicine
• St. Johns Internal Medicine PC
• Tabitha Ann Steere, FNP-C
• Erin Ashley Stehlik
• Kelly J Stewart, PT
• Megan Stoddard
• Erika Frances Sturgis

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.