NPIMap

Organization Active NPI

Sara Kellogg DDS PC

  • Dentist
  • Jackson, MI
National Provider Identifier
1669916227
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019574 Issued in MI
Legal business name
SARA KELLOGG DDS PC
Practice address
2633 Shirley Dr
Jackson, MI 49201-8633
Phone
(517) 787-2516
Fax
(517) 787-7734
NPI assigned
Dec 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Authorized official

Name
Dr. Sara Kellogg, DDS
Title
DDS/Owner
Phone
(517) 787-2516

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2901019574 MI Primary

Addresses

Primary practice location

2633 Shirley Dr
Jackson, MI 49201-8633

Mailing address

2633 Shirley Dr
Jackson, MI 49201-8633
Phone (517) 787-2516

National Provider Directory

National Provider Directory

Locations

2633 Shirley Dr
Jackson, MI 49201
Phone (517) 787-2516

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1669916227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 SHIRLEY DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018633",
            "telephone_number": "517-787-2516",
            "fax_number": "517-787-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 SHIRLEY DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018633",
            "telephone_number": "517-787-2516",
            "fax_number": "517-787-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARA KELLOGG DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "KELLOGG",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "517-787-2516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.