NPIMap

Organization Active NPI

Marquette County Health Department Dental Clinic

  • General Practice Dentistry
  • Marquette, MI
National Provider Identifier
1922212901
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MARQUETTE COUNTY HEALTH DEPARTMENT DENTAL CLINIC
Practice address
989 W Washington St Ste 104
Marquette, MI 49855-4073
Phone
(906) 226-9992
NPI assigned
May 9, 2007
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. Randall M Johnson, M.D.
Title
Medical Director Health Officer
Phone
(906) 315-2607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X MI Primary

Addresses

Primary practice location

989 W Washington St Ste 104
Marquette, MI 49855-4073

Mailing address

184 US Highway 41 E
Negaunee, MI 49866
Phone (906) 475-9977

Other identifiers 2

IdentifierTypeStateIssuer
88131OtherMIDELTA DENTAL
D80157OtherMIBCBS OF MI

National Provider Directory

National Provider Directory
Tax ID family
County of Marquette3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

989 W Washington St
Ste 104
Marquette, MI 49855
Phone (906) 226-9982

Practitioners & affiliated clinicians

Practitioners 6

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": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922212901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 US HIGHWAY 41 E",
            "city": "NEGAUNEE",
            "state": "MI",
            "postal_code": "49866",
            "telephone_number": "906-475-9977",
            "fax_number": "906-475-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 W WASHINGTON ST STE 104",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554073",
            "telephone_number": "906-226-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARQUETTE COUNTY HEALTH DEPARTMENT DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR HEALTH OFFICER",
        "authorized_official_telephone_number": "906-315-2607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "88131",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "D80157",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, 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.