Individual provider Active NPI

William M Northway, D.D.S.,M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Traverse City, MI
National Provider Identifier
1801983531
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Practice address
12776 S West Bay Shore Dr
Traverse City, MI 49684-5451
Phone
(231) 946-0070
Fax
(231) 946-6026
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X MI Primary

Addresses

Primary practice location

12776 S West Bay Shore Dr
Traverse City, MI 49684-5451

Mailing address

12776 S West Bay Shore Dr
Traverse City, MI 49684-5451
Phone (231) 946-0070

Other identifiers 1

IdentifierTypeStateIssuer
4852715MedicaidMI

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Northway and Hall Orthodontics PLLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1801983531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12776 S WEST BAY SHORE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845451",
            "telephone_number": "231-946-0070",
            "fax_number": "231-946-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12776 S WEST BAY SHORE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845451",
            "telephone_number": "231-946-0070",
            "fax_number": "231-946-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHWAY",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4852715",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.