ACCESS DENTAL GROUP PLLC (NPI# 1093819344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093819344 |
| Entity Type | Organization |
| Organization Name | ACCESS DENTAL GROUP PLLC |
| Practice Address |
550 Munson Ave Suite 102 Traverse City MI 49686 |
| Practice Telephone | 2319358461 |
| Practice Fax Number | 2319358467 |
| Mailing Telephone | 2319358461 |
| Mailing Fax Number | 2319358467 |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. THERESA MARIE FOCHTMAN (OFFICE MANAGER) |
| Authorized Official Telephone | 2319358461 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
012813 | MI | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
012865 | MI | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
014902 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | UNITED CONCORDIA | 823434 | 01 |
| MI | BCBS OF MS | D80295 | 01 |
| MI | BCBS OF MI | D802395 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568613958 | Access Dental Group Pllc | Dentist | 13620 38th Ave, #7e, Flushing, NY 11354-4233 | 2008-10-03 |
| Street Address |
550 MUNSON AVE SUITE 102 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205839131 | William H. George | Internal Medicine | 550 Munson Ave, Traverse City, MI 49686 | 2005-05-24 |
| 1265054936 | Erynne Louise Russell | Speech-Language Pathologist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2020-05-15 |
| 1821624545 | Susan Carol Spencer | Speech-Language Pathologist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2020-03-13 |
| 1346807617 | Mary Priestly | Physician Assistant | 550 Munson Ave, Traverse City, MI 49686-3580 | 2019-05-22 |
| 1194380493 | Kimberly A Chandler | Health Educator | 550 Munson Ave, Traverse City, MI 49686-3580 | 2019-05-02 |
| 1942770946 | Caroline Kiley | Physical Therapist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-12-03 |
| 1851861850 | Grace Blankenhagen | Physical Therapist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-12-03 |
| 1316429863 | Elizabeth Marie Teklinski | Counselor | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-08-31 |
| 1326544230 | Kaitlyn Troutman | Nurse Practitioner | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-04-02 |
| 1598267254 | Teresa Lynn Hearne | Physical Therapist | 550 Munson Ave, Traverse City, MI 49686-3580 | 2018-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| 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 |
|---|---|---|---|---|
| 1902397425 | Mark David Krull | Dentist | 13300 S West Bay Shore Dr Ste 1, Traverse City, MI 49684-5571 | 2018-05-21 |
| 1104355148 | Daniel Robert Fisher | Dentist | 10767 E Traverse Hwy Ste B, Traverse City, MI 49684-6219 | 2017-06-04 |
| 1619238987 | Matthew Jonathon Green | Dentist | 421 Second St, Traverse City, MI 49684-2004 | 2012-06-04 |
| 1881912491 | Grandview Dental Care Pllc | Dentist | 421 2nd St Ste 1, Traverse City, MI 49684-2004 | 2010-05-06 |
| 1891937470 | Timothy Donald Wentzloff | Dentist | 876 E Front St, Traverse City, MI 49686-2704 | 2009-03-30 |
| 1699930453 | Heather Anne Pfefferle | Dentist | 1429 Barlow St., Traverse City, MI 49686 | 2008-07-22 |
| 1497956643 | Ronald C. Chao | Dentist | 2815 Garfield Rd N, Traverse City, MI 49686-5005 | 2007-05-29 |
| 1902019623 | Grapevine Denture Service | Dentist | 865 Us Highway 31 S, Traverse City, MI 49684-8716 | 2007-05-08 |
| 1902925506 | Thomas C. Salon | Dentist | 1061 E Front St, Traverse City, MI 49686-2707 | 2007-03-28 |
| 1801925854 | Stanley M Smyka | Dentist | 1208 E 8th St, Traverse City, MI 49686-2939 | 2007-03-05 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
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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.