NPIMap

Organization Active NPI

Alpha Omega Dental Center PLLC

  • Dental Clinic/Center
  • Marquette, MI
National Provider Identifier
1710093992
Registry record updated Mar 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2901016962 Issued in MI
Legal business name
ALPHA OMEGA DENTAL CENTER PLLC
Practice address
1550 Commerce Dr
Marquette, MI 49855-8640
Phone
(906) 225-1100
Fax
(906) 225-0889
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2024

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

Authorized official

Name
Dr. Cynthia Mae Wiggins, DDSNPI 1164648200
Title
Owner - Sole Member
Phone
(906) 225-1100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2901016962 MI Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

1550 Commerce Dr
Marquette, MI 49855-8640

Mailing address

1550 Commerce Dr
Marquette, MI 49855-8640
Phone (906) 225-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170112000216 MI Part B Supplier - Clinic/Group Practice 5496058554 Receives reassigned benefits from 1 practitioner
Practice locations: Marquette, MI

National Provider Directory

National Provider Directory

Locations

1550 Commerce Dr
Marquette, MI 49855
Phone (906) 225-1100

Practitioners & affiliated clinicians

Practitioners 1

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": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709424000000",
    "number": "1710093992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 COMMERCE DR",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498558640",
            "telephone_number": "906-225-1100",
            "fax_number": "906-225-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 COMMERCE DR",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498558640",
            "telephone_number": "906-225-1100",
            "fax_number": "906-225-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA OMEGA DENTAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-03-03",
        "certification_date": "2024-03-03",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "OWNER - SOLE MEMBER",
        "authorized_official_telephone_number": "906-225-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "2901016962",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.