Active NPI
Nicolas Arthur Deboer, DDS
- Dentist
- Norton Shores, MI
National Provider Identifier
1679912323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901020968
- Practice address
- 1221 E Sherman Blvd
Norton Shores, MI 49444-1811 - Phone
- (231) 739-5105
- Fax
- (231) 739-7432
- NPI assigned
- Jun 17, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901020968 | MI | Primary |
Addresses
Primary practice location
1221 E Sherman Blvd
Norton Shores, MI 49444-1811
Mailing address
1221 E Sherman Blvd
Norton Shores, MI 49444-1811
Phone (231) 739-5105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901020968 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoreline Dental PLLC | Past | Accepting new patients | |
| Shoreline Dental Associates, P.C. | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Muskegon, MI
- NPI 1144327412
-
- General Practice Dentistry
- Norton Shores, MI
- NPI 1013211093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371427200000",
"number": "1679912323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 E SHERMAN BLVD",
"city": "NORTON SHORES",
"state": "MI",
"postal_code": "494441811",
"telephone_number": "231-739-5105",
"fax_number": "231-739-7432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 E SHERMAN BLVD",
"city": "NORTON SHORES",
"state": "MI",
"postal_code": "494441811",
"telephone_number": "231-739-5105",
"fax_number": "231-739-7432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBOER",
"first_name": "NICOLAS",
"middle_name": "ARTHUR",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-17",
"last_updated": "2013-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901020968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norton Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.