Maple Family Dentistry PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MAPLE FAMILY DENTISTRY PLLC

Practice address

1548 W Maumee St Ste a
Adrian, MI 49221-1382

Phone

(517) 920-4951

Fax

(517) 759-4027

NPI assigned

Sep 13, 2017

Organization subpart

No

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

Authorized official

Name

Raquel Amador

Title

Office Manager

Phone

(517) 920-4951

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861911596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1548 W MAUMEE ST STE A",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211382",
            "telephone_number": "517-920-4951",
            "fax_number": "517-759-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1548 W MAUMEE ST STE A",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211382",
            "telephone_number": "517-920-4951",
            "fax_number": "517-759-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "AMADOR",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "517-920-4951"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Danyale Manica
• Nicole Juliana Elizabeth Mannion, LMT
• Amy Marie Mansfield, BS
• Salah Eldein Mansour, PA-C
• Angela Marie Manwaring, PT
• Mark a Mastellotto Ddspc
• Mark a. Mastellotto
• Donna J Markham, PHD
• Stephen Glen Markham, RN
• Kathleen Markovich

• Dental Clinic/Center in Adrian, MI
• Providers in Adrian, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.