Justin P Terry DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JUSTIN P TERRY DDS PLLC

Practice address

504 Water St
Manistee, MI 49660-1544

Phone

(231) 723-7957

NPI assigned

Nov 26, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Justin Park Terry, DDSNPI 1134745169

Title

Owner

Phone

(231) 799-5665

Specialties & licenses 1

Addresses

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin Park Terry, DDS

  • Dentist
  • Muskegon, MI
  • NPI 1134745169
  NPD Authorized official
• Daniel Gardner, DDS

  • General Practice Dentistry
  • Manistee, MI
  • NPI 1043797814
  NPD (past)
• Layne Christopher Godzina, D.D.S.

  • Dentist
  • Manistee, MI
  • NPI 1144364381

  General Practice

  NPD (past)
• Geoffrey Roland Paine, D.D.S.

  • General Practice Dentistry
  • Manistee, MI
  • NPI 1366584880
  NPD (past)

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

{
    "created_epoch": "1764115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764115200000",
    "number": "1750243853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1783 BLAKETON DR",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495341702",
            "telephone_number": "231-799-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 WATER ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496601544",
            "telephone_number": "231-723-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN P TERRY DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-26",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "PARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-799-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christa Marie Johnson, D.C.
• Jill Rene Johnson, LMSW
• Jordan Johnson
• Krystal Kay Johnston, M.D.
• Holly Joseph
• Nicole Kanomata, FNP
• Charles Joseph Keil, O.D.
• Michael Keith
• Faith Yung Min Kelley, FNP-BC
• Kenneth a Borenitsch D O P C

• General Practice Dentistry in Manistee, MI
• Providers in Manistee, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; 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.