DR. MICHAEL R DOCTOR (NPI# 1255443321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255443321 |
Entity Type | Individual |
Full Name | DR. MICHAEL R DOCTOR |
Credential | D.D.S., M.S. |
Practice Address |
2115 M 119 Petoskey MI 49770-8914 |
Practice Telephone | 2313472518 |
Practice Fax Number | 2313478530 |
Mailing Telephone | 2313472518 |
Mailing Fax Number | 2313478530 |
Enumeration Date | 2006-08-31 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
2901014067 | MI | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | BCBS OF MICHIGAN-DENTAL | D140670 | 01 |
MI | 288090 | 05 | |
MI | BCBS OF MICHIGAN-MEDICAL | 5166284 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740625656 | Michael Benjamin Doctor | Emergency Medicine | 1000 10th Ave, New York, NY 10019-1147 | 2013-05-06 |
Street Address |
2115 M 119 |
City | PETOSKEY |
State | MI |
Zip Code | 49770-8914 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316299365 | Northern Periodontics & Implant Dentistry, P.C. | Dentist | 2115 M 119, Petoskey, MI 49770-8914 | 2012-10-15 |
1750493896 | Vaughn A Mcgraw | Dentist | 2115 M 119, Petoskey, MI 49770-8914 | 2006-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
Find all providers in zip 49770 |
Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316299365 | Northern Periodontics & Implant Dentistry, P.C. | Dentist | 2115 M 119, Petoskey, MI 49770-8914 | 2012-10-15 |
1750493896 | Vaughn A Mcgraw | Dentist | 2115 M 119, Petoskey, MI 49770-8914 | 2006-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396352175 | Khaled Sinjab | Dentist | 8641 W Grand River Ave Ste 8, Brighton, MI 48116-4330 | 2020-09-25 |
1174134605 | Bay Periodontics | Dentist | 1666 Towsley Ln, Ann Arbor, MI 48105-9336 | 2020-08-10 |
1699309500 | Ann Arbor Periodontics | Dentist | 2715 Packard St Ste C, Ann Arbor, MI 48108-3365 | 2020-02-29 |
1679044192 | David I Lipton D.d.s., M.s. | Dentist | 50 W Big Beaver Rd Ste 150, Bloomfield Hills, MI 48304-3911 | 2018-12-10 |
1326576646 | Thomas James Fleszar | Dentist | 1175 Harrow Cir, Bloomfield Hills, MI 48304-3922 | 2017-05-31 |
1386185445 | Khairunnisa Quraishi Dds PC | Dentist | 37184 Dequindre Rd, Sterling Heights, MI 48310-3536 | 2017-03-09 |
1578002812 | Michigan Periodontics Group LLC | Dentist | 350 N Main St Ste 110, Chelsea, MI 48118-1486 | 2017-02-20 |
1518410836 | Mohamed Elazhri | Dentist | 27200 Parkview Blvd Apt 901, Warren, MI 48092-2820 | 2016-08-03 |
1316314834 | Whitney Dunn Weiner | Dentist | 2425 E Lincoln St, Suite 100, Birmingham, MI 48009-7100 | 2015-09-01 |
1639569684 | Divine Family Denistry | Dentist | 27845 Gratiot Ave, Roseville, MI 48066-4848 | 2015-01-29 |
Find all providers with the same taxonomy |
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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.