Active NPI
John Allen, DDS
- General Practice Dentistry
- Farwell, MI
National Provider Identifier
1750471868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10385
- Practice address
- 301 W Main St
Farwell, MI 48622-8753 - Phone
- (989) 588-4121
- Fax
- (989) 588-3191
- NPI assigned
- Oct 13, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10385 | MI | Primary |
Addresses
Primary practice location
301 W Main St
Farwell, MI 48622-8753
Mailing address
PO Box 309
Farwell, MI 48622-0309
Phone (989) 588-4121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D800279 | Other | MI | BLUE CROSS BLUE SHIELD |
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
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10385 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Farwell Dental, PLLC | General Practice | Past | Accepting new patients |
| Colleen Quesada DMD PLLC | 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.
-
dba Farwell Family Dentistry
- General Practice Dentistry
- Farwell, MI
- NPI 1154198273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750471868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 309",
"city": "FARWELL",
"state": "MI",
"postal_code": "486220309",
"telephone_number": "989-588-4121",
"fax_number": "989-588-3191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 W MAIN ST",
"city": "FARWELL",
"state": "MI",
"postal_code": "486228753",
"telephone_number": "989-588-4121",
"fax_number": "989-588-3191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "JOHN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "10385",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "D800279",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farwell, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.