Individual provider Active NPI

Christopher Kevin Latocha, DDS

  • Dentist
  • Mackinaw City, MI
National Provider Identifier
1912127598
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
16009 Issued in MI
Practice address
230 W Central
Mackinaw City, MI 49701
Phone
(231) 436-7400
Fax
(231) 436-7446
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 16009 MI Primary

Addresses

Primary practice location

230 W Central
Mackinaw City, MI 49701

Mailing address

PO Box 854
Mackinaw City, MI 49701-0854
Phone (231) 436-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16009MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912127598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 854",
            "city": "MACKINAW CITY",
            "state": "MI",
            "postal_code": "497010854",
            "telephone_number": "231-436-7400",
            "fax_number": "231-436-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W CENTRAL",
            "city": "MACKINAW CITY",
            "state": "MI",
            "postal_code": "49701",
            "telephone_number": "231-436-7400",
            "fax_number": "231-436-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATOCHA",
        "first_name": "CHRISTOPHER",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "16009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mackinaw City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.