Active NPI
Steven J Feddick, D.D.S.
- Dentist
- Wayland, MI
National Provider Identifier
1982085320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901021561
- Practice address
- 404 W Superior St
Wayland, MI 49348-1223 - Phone
- (269) 792-0144
- NPI assigned
- Jun 11, 2015
- Last updated
- Jun 25, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901021561 | MI | Primary |
Addresses
Primary practice location
404 W Superior St
Wayland, MI 49348-1223
Mailing address
404 W Superior St
Wayland, MI 49348-1223
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2901021561 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robinson Community Dental Clinic | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Wayland Dental Clinic
- Dental Clinic/Center
- Wayland, MI
- NPI 1174963375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435190400000",
"number": "1982085320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 W SUPERIOR ST",
"city": "WAYLAND",
"state": "MI",
"postal_code": "493481223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 W SUPERIOR ST",
"city": "WAYLAND",
"state": "MI",
"postal_code": "493481223",
"telephone_number": "269-792-0144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDDICK",
"first_name": "STEVEN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-11",
"last_updated": "2015-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901021561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.