NPIMap

Organization Active NPI

Grand Blanc Periodontal Associates

  • Periodontics
  • Grand Blanc, MI
National Provider Identifier
1871560508
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
012478 Issued in MI
Legal business name
GRAND BLANC PERIODONTAL ASSOCIATES
Practice address
8185 Holly Rd
Suite 19
Grand Blanc, MI 48439-2444
Phone
(810) 695-6444
Fax
(810) 695-4414
NPI assigned
Mar 1, 2006
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. Benson C Duff, DDS,MS,MS
Title
Ceo
Phone
(810) 695-6444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 012478 MI Primary

Addresses

Primary practice location

8185 Holly Rd
Suite 19
Grand Blanc, MI 48439-2444

Mailing address

8185 Holly Rd
Suite 19
Grand Blanc, MI 48439-2444
Phone (810) 695-6444

National Provider Directory

National Provider Directory

Locations

8185 Holly Rd
Ste 19
Grand Blanc, MI 48439
Phone (810) 695-6444

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871560508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8185 HOLLY RD",
            "address_2": "SUITE 19",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392444",
            "telephone_number": "810-695-6444",
            "fax_number": "810-695-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8185 HOLLY RD",
            "address_2": "SUITE 19",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392444",
            "telephone_number": "810-695-6444",
            "fax_number": "810-695-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND BLANC PERIODONTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUFF",
        "authorized_official_first_name": "BENSON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-695-6444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MS,MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "012478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, 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.