UPPER GREAT LAKES FAMILY HEALTH CENTER (NPI# 1205217239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205217239 |
| Entity Type | Organization |
| Organization Name | UPPER GREAT LAKES FAMILY HEALTH CENTER |
| Practice Address |
1550 W Quincy St Hancock MI 49930-1223 |
| Practice Telephone | 9064823621 |
| Practice Fax Number | 9064823676 |
| Mailing Telephone | 9064823621 |
| Mailing Fax Number | 9064823676 |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2015-06-16 |
| Authorized Official Name | DONALD A SIMILA (CEO) |
| Authorized Official Telephone | 9064831325 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
| 1659889673 | Upper Great Lakes Family Health Center | Psychiatry & Neurology | 965 Fee Rd Rm A229, East Lansing, MI 48824-6410 | 2018-01-11 |
| 1336563832 | Upper Great Lakes Family Health Center | Clinic/Center | 751 S 7th Street, Ontonagon, MI 49953-1450 | 2014-02-05 |
| 1508289273 | Upper Great Lakes Family Health Center | Clinic/Center | 1500 W Ice Lake Road, Iron River, MI 49935-8509 | 2014-01-30 |
| 1740603885 | Upper Great Lakes Family Health Center | Clinic/Center | 945 Ninth Street, Lake Linden, MI 49945-1100 | 2014-01-25 |
| 1811325103 | Upper Great Lakes Family Health Center | Clinic/Center | 600 Macinnes Drive, Houghton, MI 49931-1144 | 2013-10-23 |
| 1700103777 | Upper Great Lakes Family Health Center | Family Medicine | 301 Explorer Street, Gwinn, MI 49841-2813 | 2010-04-29 |
| 1104158690 | Upper Great Lakes Family Health Center | Family Medicine | 135 East M 35, Gwinn, MI 49841-9159 | 2010-02-08 |
| 1396295721 | Upper Great Lakes Family Health Center | Dentist | 56720 Calumet Ave, Calumet, MI 49913-1967 | 2016-10-10 |
| 1164893491 | Upper Great Lakes Family Health Center | Dentist | 301 Explorer St, Gwinn, MI 49841-2813 | 2015-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UPPER GREAT LAKES FAMILY HEALTH CENTER | 506 Campus Dr, Hancock, MI 49930-1569 |
| Street Address |
1550 W QUINCY ST |
| City | HANCOCK |
| State | MI |
| Zip Code | 49930-1223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982710802 | Ronald Joseph Fisher | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2006-08-22 |
| 1831698539 | Amy Chard | Dental Hygienist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2018-02-08 |
| 1386143089 | Amy Datto | Dental Hygienist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2018-02-08 |
| 1346749041 | Sarah Maki | Dental Assistant | 1550 W Quincy St, Hancock, MI 49930-1223 | 2018-02-08 |
| 1669971362 | Ann Lepisto | Dental Hygienist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2018-02-08 |
| 1730688433 | Megan Bugweg | Dental Hygienist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2018-02-08 |
| 1538668231 | Shari Billeck | Dental Assistant | 1550 W Quincy St, Hancock, MI 49930-1223 | 2018-02-08 |
| 1932652005 | Justin Slis | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2016-07-25 |
| 1568790293 | Sarah Mettlach | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2009-11-18 |
| 1255458758 | Anthony Charles Sarazin | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2007-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437627643 | Karen Byrnes | Registered Nurse | Hancock Va Cboc, 787 Market St. Suite 9, Hancock, MI 49930 | 2018-11-06 |
| 1881117562 | Angelica Monique Nunez | Specialist/Technologist | 601 Quincy St, Hancock, MI 49930 | 2017-07-25 |
| 1831581164 | Superior Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 20075 Third Street, Hancock, MI 49930 | 2015-02-24 |
| 1861703258 | Superior Smiles | Dentist | 1550 West Quincy St, Hancock, MI 49930 | 2010-06-30 |
| 1164633780 | Kathryn Mary Salmi | Counselor | 100 Quincy Street, Hancock, MI 49930 | 2007-05-25 |
| 1093828535 | Mary Katherine Van Camp | Social Worker | 787 Market St., Suites 9 & 10, Hancock, MI 49930 | 2006-08-17 |
| 1083627392 | Kim Kathleen Green | Social Worker | 787 Market Street, Hancock, MI 49930 | 2006-08-15 |
| 1346257672 | James William Sarazin | Dentist | 528 Quincy Street, Hancock, MI 49930 | 2006-08-01 |
| 1114951829 | Patricia J Tikkanen | Social Worker | 200 Michigan St Ste 321, Hancock, MI 49930 | 2006-07-10 |
| 1487639829 | Thomas Collins | Social Worker | 920 Water Street, Hancock, MI 49930 | 2005-12-08 |
| Find all providers in zip 49930 | ||||
| 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 |
|---|---|---|---|---|
| 1861703258 | Superior Smiles | Dentist | 1550 West Quincy St, Hancock, MI 49930 | 2010-06-30 |
| 1457479214 | Dennis Destefano | Dentist | 24651 State Hwy 97, Hancock, NY 13783-2233 | 2007-03-27 |
| 1053462473 | Leonard William Beesley | Dentist | 1111 Hecla St, Hancock, MI 49930-1035 | 2007-01-13 |
| 1306931720 | Timothy Jon Carlson | Dentist | 657 Atlantic Ave, Hancock Dental Clilnic, P.a, Hancock, MN 56244 | 2006-10-03 |
| 1982710802 | Ronald Joseph Fisher | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2006-08-22 |
| 1427164680 | Robert D Richards Dds PC | Dentist | 896 Campus Drive, Hancock, MI 49930-1571 | 2006-08-21 |
| 1346257672 | James William Sarazin | Dentist | 528 Quincy Street, Hancock, MI 49930 | 2006-08-01 |
| 1932652005 | Justin Slis | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2016-07-25 |
| 1144435421 | Robert Donold Richards | Dentist | 896 Campus Drive, Hancock, MI 49931-1571 | 2007-05-11 |
| 1356467203 | Robert Nominelli | Dentist | 1550 W Quincy St, Hancock, MI 49930-1223 | 2007-03-22 |
| Find all providers in HANCOCK | ||||
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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.