NPIMap

Organization Active NPI

Robert I. Mattice, DDS, PC

  • Dentist
  • Manistee, MI
National Provider Identifier
1992240774
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8859 Issued in MI
Legal business name
ROBERT I. MATTICE, DDS, PC
Practice address
422 1St St
Manistee, MI 49660-1504
Phone
(231) 723-2954
Fax
(231) 723-3910
NPI assigned
Jan 3, 2017
Last updated
Jan 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Authorized official

Name
Robert Mattice, DDSNPI 1669570644
Title
President
Phone
(231) 723-2954

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 8859 MI Primary

Addresses

Primary practice location

422 1St St
Manistee, MI 49660-1504

Mailing address

422 1St St
Manistee, MI 49660-1504
Phone (231) 723-2954

National Provider Directory

National Provider Directory

Locations

422 1st St
Manistee, MI 49660
Phone (231) 723-1198

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1992240774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 1ST ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496601504",
            "telephone_number": "231-723-2954",
            "fax_number": "231-723-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 1ST ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496601504",
            "telephone_number": "231-723-2954",
            "fax_number": "231-723-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT I. MATTICE, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "MATTICE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-723-2954",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "8859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistee, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.