Mid Michigan Dental Implant Center, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MID MICHIGAN DENTAL IMPLANT CENTER, PC

Practice address

800 N State St Ste 151
Stanton, MI 48888-9708

Phone

(866) 438-6464

Fax

(989) 831-9020

NPI assigned

Feb 6, 2018

Organization subpart

No

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

Authorized official

Name

Dr. David Lee Dockham, DDS, PC

Title

President

Phone

(866) 438-6464

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517875200000",
    "number": "1992204952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N STATE ST STE 151",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889708",
            "telephone_number": "866-438-6464",
            "fax_number": "989-831-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N STATE ST STE 151",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488889708",
            "telephone_number": "866-438-6464",
            "fax_number": "989-831-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID MICHIGAN DENTAL IMPLANT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A",
        "authorized_official_last_name": "DOCKHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-438-6464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PC"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013734",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodie L Mastaw
• Sarah J McDiarmid, BA
• Beth McGinn, CPSS
• Rebecca Ruth Mead
• Jaiden S Meyer
• Mid-Michigan District Health Department
• Mid-Michigan District Health Department
• Mid-Michigan District Health Department
• Jill Marie Miller, RN
• Phillip Millerov

• General Practice Dentistry in Stanton, MI
• Providers in Stanton, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; 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.