NPIMap

Organization Active NPI

Michigan Endodontics PC

  • Endodontics
  • Port Huron, MI
National Provider Identifier
1861606212
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
MICHIGAN ENDODONTICS PC
Practice address
1982 Holland Ave
Port Huron, MI 48060
Phone
(810) 985-7300
Fax
(810) 985-7803
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Steven E Fegan, DDSNPI 1962537050
Title
Secretary
Phone
(586) 573-6860

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

1982 Holland Ave
Port Huron, MI 48060

Mailing address

11300 E 13 Mile Rd
Warren, MI 48093
Phone (586) 573-6860

National Provider Directory

National Provider Directory
Tax ID family
Michigan Endodontics PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861606212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-6860",
            "fax_number": "586-573-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1982 HOLLAND AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-985-7300",
            "fax_number": "810-985-7803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN ENDODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FEGAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "586-573-6860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • 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.