Amanda Elizabeth Coates, RDH
Individual provider Active NPI Dental Hygienist · Davison, MI
NPI 1831647486 · NPPES record last updated Sep 12, 2016
Key facts
- NPI
- 1831647486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 2902017919 (MI)
- Practice address
- 10111 E Atherton Rd
Davison, MI 48423-8704 - Phone
- (810) 836-3720
- NPI assigned
- Sep 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2902017919 | MI | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2902017919 | MI | Yes |
Addresses
Primary practice location
10111 E Atherton Rd
Davison, MI 48423-8704
Mailing address
10111 E Atherton Rd
Davison, MI 48423-8704
Phone (810) 836-3720
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124Q00000X | Medicaid | MI |
Other providers in Davison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.