Superior Smiles

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901016316 Issued in MI

Legal business name

SUPERIOR SMILES

Practice address

1550 West Quincy St
Hancock, MI 49930

Phone

(906) 482-3621

Fax

(906) 482-3676

NPI assigned

Jun 30, 2010

Organization subpart

No

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

Authorized official

Name

Nicole Ann Hebner

Title

Office Manager

Phone

(906) 482-3621

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1861703258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "49931",
            "telephone_number": "906-482-3621",
            "fax_number": "906-482-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 WEST QUINCY ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "49930",
            "telephone_number": "906-482-3621",
            "fax_number": "906-482-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "HEBNER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "906-482-3621"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4930642",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzan Marie Stacknik, D.D.S., M.S.
• Lloyd M Starks, MT
• Amelia Stefanac
• Maria Kristiin Sturos, P.T.A.
• Superior Prosthetics and Orthotics
• Superior View Radiology PLC
• Nancy K Taglione, LMSW
• Jodi Lynn Tervo, PTA
• Ndiaga Thiam
• Robert William Thomas, RRT

• General Practice Dentistry in Hancock, MI
• Providers in Hancock, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.