NPIMap

Organization Active NPI

Clio Dental Center

  • General Practice Dentistry
  • Clio, MI
National Provider Identifier
1891730487
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
016386 Issued in MI
Legal business name
CLIO DENTAL CENTER
Practice address
145 W Vienna St
Clio, MI 48420-1333
Phone
(810) 687-9700
Fax
(810) 687-2695
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Authorized official

Name
Timothy J Miller, DDSNPI 1609055151
Title
Owner
Phone
(810) 687-9700

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 016386 MI Primary

Addresses

Primary practice location

145 W Vienna St
Clio, MI 48420-1333

Mailing address

145 W Vienna St
Clio, MI 48420-1333
Phone (810) 687-9700

Other identifiers 1

IdentifierTypeStateIssuer
4418480MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1891730487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W VIENNA ST",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484201333",
            "telephone_number": "810-687-9700",
            "fax_number": "810-687-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W VIENNA ST",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484201333",
            "telephone_number": "810-687-9700",
            "fax_number": "810-687-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIO DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-687-9700",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "016386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4418480",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clio, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.