Ted a Fornetti DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901019408 Issued in MI

Legal business name

TED A FORNETTI DDS PC

Practice address

1115 South Hemlock
Suite 1
Iron Mountain, MI 49801

Phone

(906) 774-4444

Fax

(906) 774-6949

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Ted A Fornetti, DDS

Title

Dentist

Phone

(906) 774-4444

Specialties & licenses 3

Addresses

Other names 1

• Ted J Fornetti DDS PC Other name

Locations

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811041239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SOUTH HEMLOCK",
            "address_2": "SUITE 1",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "49801",
            "telephone_number": "906-774-4444",
            "fax_number": "906-774-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 SOUTH HEMLOCK",
            "address_2": "SUITE 1",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "49801",
            "telephone_number": "906-774-4444",
            "fax_number": "906-774-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED A FORNETTI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORNETTI",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "906-774-4444",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017898",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019408",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "10422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ted J Fornetti DDS PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Dentistry in Iron Mountain, MI
• Providers in Iron Mountain, 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 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.