Individual provider Active NPI

Matthew Free

  • Dentist
  • Alpena, MI
National Provider Identifier
1811345572
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021896 Issued in MI
Practice address
100 Woods Cir Ste 600
Alpena, MI 49707-1445
Phone
(866) 878-6547
NPI assigned
Jun 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021896 MI Primary

Addresses

Primary practice location

100 Woods Cir Ste 600
Alpena, MI 49707-1445

Mailing address

100 Woods Cir Ste 600
Alpena, MI 49707-1445
Phone (866) 878-6547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171129003396 MI Order and Referring Only - DentistPractitioner - Dentist 2769749787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021896MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1811345572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODS CIR STE 600",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071445",
            "telephone_number": "866-878-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS CIR STE 600",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071445",
            "telephone_number": "866-878-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREE",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-02",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

Verify at the official NPI Registry.