BRUCE D EDWARDS (NPI# 1639410178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639410178 |
| Entity Type | Individual |
| Full Name | BRUCE D EDWARDS |
| Credential | DDS |
| Practice Address |
2115 M-119 Petoskey MI 49770 |
| Practice Telephone | 2313472518 |
| Practice Fax Number | 2313478530 |
| Mailing Telephone | 2313472518 |
| Mailing Fax Number | 2313478530 |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2017-12-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
2901020869 | MI | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
2901020869 | MI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174729305 | Bruce W Edwards | Dentist | 270 26th St Ste 302, Santa Monica, CA 90402-2567 | 2007-06-25 |
| 1477635357 | Bruce L Edwards | Allergy & Immunology | 321 Crossways Park Dr Ste 1a, Woodbury, NY 11797-2066 | 2006-10-19 |
| 1992080345 | Bruce R Edwards | Pharmacist | 390 E 162nd St, South Holland, IL 60473-2141 | 2011-10-17 |
| 1366761488 | Bruce Daniel Edwards IIi | Community Health Worker | 500 Hospital Dr, Warrenton, VA 20186-3027 | 2010-05-28 |
| 1457451387 | Bruce Marshall Edwards | Nurse Anesthetist, Certified Registered | 835 S Van Buren St, Green Bay, WI 54301 | 2006-09-22 |
| 1316049935 | Bruce Leon Edwards | Counselor | 124 Mallard Street, Greenville, SC 29601-4046 | 2006-09-03 |
| 1851352298 | Bruce N Edwards | Orthopaedic Surgery | 11110 Medical Campus Rd, Suite 205, Hagerstown, MD 21742-6700 | 2006-03-28 |
| 1245224781 | Bruce Monroe Edwards | Preventive Medicine | 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 | 2005-09-09 |
| 1750389136 | Bruce M Edwards | Audiologist | 1500 East Medical Center Dr, 1st Floor Taubman Center Recp A, Ann Arbor, MI 48109-5312 | 2005-07-11 |
| Street Address |
2115 M-119 |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770 |
| 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 |
|---|---|---|---|---|
| 1255443321 | Michael R Doctor | Dentist | 2115 M 119, Petoskey, MI 49770-8914 | 2006-08-31 |
| 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.