NPIMap

Organization Active NPI

Marshall Family Dentistry PLLC

  • Dentist
  • Marshall, MI
National Provider Identifier
1821537010
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13841 Issued in MI
Legal business name
MARSHALL FAMILY DENTISTRY PLLC
Practice address
207 Winston Dr
Marshall, MI 49068-8526
Phone
(269) 781-6300
Fax
(269) 781-8459
NPI assigned
Feb 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Authorized official

Name
Dr. Douglas Alan Vandermeulen, DDSNPI 1255411096
Title
Owner
Phone
(269) 781-6300

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 13841 MI Primary

Addresses

Primary practice location

207 Winston Dr
Marshall, MI 49068-8526

Mailing address

207 Winston Dr
Marshall, MI 49068-8526
Phone (269) 781-6300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1821537010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 WINSTON DR",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490688526",
            "telephone_number": "269-781-6300",
            "fax_number": "269-781-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 WINSTON DR",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490688526",
            "telephone_number": "269-781-6300",
            "fax_number": "269-781-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "VANDERMEULEN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-781-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "13841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.