Tooth Time

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

2901017274 Issued in MI

Legal business name

TOOTH TIME

Practice address

7057 Stoney Creek Dr
Augusta, MI 49012-8883

Phone

(269) 731-4581

NPI assigned

Oct 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dollie M Black, RDH

Title

Director

Phone

(269) 731-4581

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730276411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7057 STONEY CREEK DR",
            "city": "AUGUSTA",
            "state": "MI",
            "postal_code": "490128883",
            "telephone_number": "269-731-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7057 STONEY CREEK DR",
            "city": "AUGUSTA",
            "state": "MI",
            "postal_code": "490128883",
            "telephone_number": "269-731-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOTH TIME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "DOLLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "269-731-4581",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "MI",
            "license": "2901017274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in Augusta, MI
• Providers in Augusta, MI by specialty
• Public Health Dentistry in Michigan

• 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.