NPIMap

Organization Active NPI

Boyne City Dental

  • Dentist
  • Boyne City, MI
National Provider Identifier
1679631923
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901013182 Issued in MI
Legal business name
BOYNE CITY DENTAL
Practice address
830 State St
Boyne City, MI 49712
Phone
(231) 582-6644
Fax
(231) 582-6853
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John Rex MoriarityNPI 1427183763
Title
Owner
Phone
(231) 582-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2901013182 MI Primary

Addresses

Primary practice location

830 State St
Boyne City, MI 49712

Mailing address

PO Box 368
830 State St
Boyne City, MI 49712
Phone (231) 582-6644

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679631923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "address_2": "830 STATE ST",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "49712",
            "telephone_number": "231-582-6644",
            "fax_number": "231-582-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 STATE ST",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "49712",
            "telephone_number": "231-582-6644",
            "fax_number": "231-582-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYNE CITY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORIARITY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "REX",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-582-8000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boyne City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.