NPIMap

Organization Active NPI

Okemos Family Dentistry, P.C.

  • Dentist
  • Okemos, MI
National Provider Identifier
1780121319
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019571 Issued in MI
Legal business name
OKEMOS FAMILY DENTISTRY, P.C.
Practice address
2277 Science Pkwy Ste 3
Okemos, MI 48864-2551
Phone
(517) 349-6669
Fax
(517) 349-5064
NPI assigned
Jan 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Dr. Justin R Cook, DDSNPI 1932319563
Title
President
Phone
(517) 349-6669

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901019571 MI Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901020108 MI

Addresses

Primary practice location

2277 Science Pkwy Ste 3
Okemos, MI 48864-2551

Mailing address

2277 Science Pkwy Ste 3
Okemos, MI 48864-2551
Phone (517) 349-6669

National Provider Directory

National Provider Directory
Tax ID family
Okemos Family Dentistry PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2277 Science Pkwy
Ste 3
Okemos, MI 48864
Phone (517) 349-6669

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": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1780121319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 SCIENCE PKWY STE 3",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642551",
            "telephone_number": "517-349-6669",
            "fax_number": "517-349-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 SCIENCE PKWY STE 3",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642551",
            "telephone_number": "517-349-6669",
            "fax_number": "517-349-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKEMOS FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-349-6669",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019571",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.