Gentle Family Dentistry

Key facts

NPI

1679015507

Entity type

Organization (NPI type 2)

Primary specialty

General Practice Dentistry 1223G0001X

License

2901014579 (MI)

Legal business name

GENTLE FAMILY DENTISTRY

Practice address

201 Bridge Park Dr
Charlevoix, MI 49720-1381

Phone

(231) 547-9516

Fax

(231) 547-9526

NPI assigned

Nov 9, 2016

Organization subpart

No

Authorized official

Name

Dr. Tracy M Nemecek, D.D.S.

Title

Doctor

Phone

(231) 547-9516

Practitioners 1

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

• Jeffrey Lee Porter, D.D.S. Dentist · Charlevoix, MI · NPI 1043488901
  NPD (past)

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 9, 2016.

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1679015507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BRIDGE PARK DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201381",
            "telephone_number": "231-547-9516",
            "fax_number": "231-547-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BRIDGE PARK DR",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201381",
            "telephone_number": "231-547-9516",
            "fax_number": "231-547-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENTLE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "NEMECEK",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "231-547-9516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Charlevoix, MI · General Practice Dentistry in Michigan