MADISON RAE MICK (NPI# 1043871254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043871254 |
| Entity Type | Individual |
| Full Name | MADISON RAE MICK |
| Credential | DMD |
| Practice Address |
24 N Saint Joseph Ave Ste G Niles MI 49120-2263 |
| Mailing Address |
237 N Michigan St Apt 505 South Bend IN 46601-0011 |
| Practice Telephone | 2692620399 |
| Mailing Telephone | 3202938520 |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2019-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2901600158 | MI | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 122 Grant St, Niles, MI 491202281 | 2692620399 |
| Street Address |
24 N SAINT JOSEPH AVE STE G |
| City | NILES |
| State | MI |
| Zip Code | 49120-2263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285652 | The Caerus Group LLC | Clinic/Center | 732 S. 11th St #197, Niles, MI 49120 | 2018-11-27 |
| 1306316971 | Vicki L Yarbro | Physical Therapist | 6 Longmeadow Village Dr. Suite 3, Niles, MI 49120 | 2018-11-27 |
| 1063831469 | Aaron Joseph Lanning | Nurse Practitioner | 42 N Saint Joseph Ave Ste 300, Niles, MI 49120 | 2014-04-14 |
| 1740601186 | Terrianne Klaeren | Occupational Therapist | 1009 Almaugus Drive, Niles, MI 49120 | 2014-01-03 |
| 1124469366 | All Needs Senior Services, Inc. | Home Health | 1723 Pucker Street Dr, Suite A, Niles, MI 49120 | 2013-07-16 |
| 1902105034 | Nile Family Pharmacy LLC | Pharmacy | 70 E. State St., Niles, MI 49120 | 2011-03-15 |
| 1629240734 | Karen L Palmer | Counselor | 115 S St Joseph Ave, Niles, MI 49120 | 2008-03-28 |
| 1124218391 | Melissa A Longley | Social Worker | 333 N. Second Street, Suite 303, Niles, MI 49120 | 2007-07-25 |
| 1841410727 | Periza Zaninovic | Dentist | 123 Marmont Street, Niles, MI 49120 | 2007-04-26 |
| 1477629087 | Stephen Williams Tankersley | Dentist | 226 S Lincoln Ave, Niles, MI 49120 | 2006-11-27 |
| Find all providers in zip 49120 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770946378 | Malgorzata Pienkowska | Dentist | 8107 N. Milwaukee, Niles, IL 60714-2803 | 2016-03-31 |
| 1053729467 | Mary Grace Kim | Dentist | 8321 W Golf Rd, Niles, IL 60714-1113 | 2014-07-29 |
| 1093089690 | Nwdg Niles LLC | Dentist | 7886 N Milwaukee Ave, Niles, IL 60714-3145 | 2012-02-28 |
| 1649589151 | Kala Sagar Madugula Dmd Inc | Dentist | 5700 Youngstown Warren Rd, Unit 107, Niles, OH 44446-4762 | 2010-09-30 |
| 1366690067 | Mia Myoungah Seo | Dentist | 876 Civic Center Dr, Niles, IL 60714-3207 | 2008-09-05 |
| 1275796591 | Ronald Patrick Giometti | Dentist | 6954 W Touhy Ave, Suite 201, Niles, IL 60714-4547 | 2008-07-07 |
| 1972777399 | Hyeokjin Son | Dentist | 1111 Lambert St, Niles, MI 49120-3439 | 2008-04-16 |
| 1659560464 | Dr John D Mcmahon Ltd | Dentist | 8100 Oakton St, Niles, IL 60714 | 2007-10-17 |
| 1033315023 | Tejas N Joshi | Dentist | 7763 N Nordica Ave, Niles, IL 60714-3311 | 2007-06-26 |
| 1578769204 | Roger J Pogorzelski | Dentist | 6759 N Milwaukee Ave, Niles, IL 60714-4418 | 2007-06-21 |
| Find all providers in NILES | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.