Mid Michigan Oral Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MID MICHIGAN ORAL SURGERY

Practice address

110 N Cochran Ave
Charlotte, MI 48813-1508

Phone

(517) 337-9759

Fax

(517) 337-8156

NPI assigned

May 23, 2008

Last updated

Jun 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark E Beckman, DDS, MSNPI 1932198835

Title

Oral Surgeon / Owner

Phone

(517) 337-9759

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mid Michigan Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Ledge, MI
  • NPI 1942468186

  O20040805000351

  Same enrollment
• Mid Michigan Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • East Lansing, MI
  • NPI 1174516413

  O20040805000351

  Same enrollment

Tax ID family

Mid Michigan Oral Surgery3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Mid Michigan Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Ledge, MI
  • NPI 1942468186
  NPD tax ID
• Mid Michigan Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • East Lansing, MI
  • NPI 1174516413
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark E Beckman, D.D.S.,M.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • East Lansing, MI
  • NPI 1932198835
  NPD Authorized official
• Vincent Vern Benivegna, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • East Lansing, MI
  • NPI 1326032988
  NPD
• Sean E Pack, DDS MD

  • Oral and Maxillofacial Surgery (Dentist)
  • East Lansing, MI
  • NPI 1083901425
  NPD

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1861650095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N COCHRAN AVE",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131508",
            "telephone_number": "517-337-9759",
            "fax_number": "517-337-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N COCHRAN AVE",
            "city": "CHARLOTTE",
            "state": "MI",
            "postal_code": "488131508",
            "telephone_number": "517-337-9759",
            "fax_number": "517-337-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID MICHIGAN ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "BECKMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ORAL SURGEON / OWNER",
        "authorized_official_telephone_number": "517-337-9759",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel McGue
• Cortney McLeod-Emerson, MSW
• Meijer Inc (Meijer Pharmacy #194)
• Michigan Dental Associates - Charlotte PC (Painless Dentistry II PLLC)
• Mid Michigan Gentle Dental
• Brionna Rene Mielke I
• Brenda Kay Moulton
• Jenna Laree Murphy, MS, RD
• Mary Murray, FNP
• James Dwight Myers, D.C.

• Oral and Maxillofacial Surgery (Dentist) in Charlotte, MI
• Providers in Charlotte, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.