Jack Hunter Behl, D.D.S.
Individual provider Active NPI General Practice Dentistry · Alpena, MI
NPI 1831177401 · NPPES record last updated Mar 26, 2015
Key facts
- NPI
- 1831177401
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2901017730 (MI)
- Practice address
- 2229 US 23 S
Alpena, MI 49707-4543 - Phone
- (989) 354-8112
- Fax
- (989) 354-3542
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150506001499 | MI | Order and Referring Only - Dentist |
3577882943 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017730 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jack H Behl DDS, PC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901017730 | MI | Yes |
Addresses
Primary practice location
2229 US 23 S
Alpena, MI 49707-4543
Mailing address
2229 US 23 S
Alpena, MI 49707-4543
Phone (989) 354-8112
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2901017730 | Other | MI | LICENSE NUMBER |
Other providers in Alpena, MI
- Baybrook Medical Center
- Wael Mohamad Baydoun
- David M Beatty
- Jason L Beatty
- Santiago Jose Becerra
- Bella Rose Skin Care PLLC
- Jordan Bellmore
- Josephine Bellmore
- Kiel Thomas Beltinck
- Bonnie Benac
All providers in Alpena, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.