BLUE WATER FAMILY DENTISTRY PC (NPI# 1396756615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396756615 |
| Entity Type | Organization |
| Organization Name | BLUE WATER FAMILY DENTISTRY PC |
| Practice Address |
4044 24th Ave Fort Gratiot MI 48059 |
| Practice Telephone | 8103852273 |
| Practice Fax Number | 8103856285 |
| Mailing Telephone | 8103852273 |
| Mailing Fax Number | 8103856285 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WILLIAM SCOTT MEYER (DENTIST) |
| Authorized Official Telephone | 8103852273 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 16113 | MI | Dental Providers |
| N | 122300000X | Dentist | 15282 | MI | Dental Providers |
| Y | 122300000X | Dentist | 16735 | MI | Dental Providers |
| Street Address |
4044 24TH AVE |
| City | FORT GRATIOT |
| State | MI |
| Zip Code | 48059 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033407242 | Adrian Shather Forbes | Dentist | 4044 24th Ave, Fort Gratiot, MI 48059-3800 | 2011-07-21 |
| 1265589014 | Ronald Tosto | Dentist | 4044 24th Ave, Fort Gratiot, MI 48059-3800 | 2007-01-04 |
| 1851448609 | W. Scott Meyer | Dentist | 4044 24th Ave, Fort Gratiot, MI 48059-3800 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679096374 | Rebecca Campau | Registered Nurse | 4985 Lakeshore Rd, Fort Gratiot, MI 48059 | 2017-07-25 |
| 1598175481 | David Kelley Sr. | Pharmacist | 4475 24th Ave., Fort Gratiot, MI 48059 | 2014-05-01 |
| 1316110968 | Apheresis and Transfusion Medicine of Port Huron Pllc | Pathology | 4970 Lakeshore Road, Fort Gratiot, MI 48059 | 2008-04-03 |
| 1275754152 | Jennifer Ann Peyerk | Physical Therapist | 3902 Arlington Ave., Fort Gratiot, MI 48059 | 2007-05-01 |
| 1013097278 | Randy John Plonka | Internal Medicine | 5979 Lakeshore, Ft Gratiot, MI 48059 | 2006-10-16 |
| 1881708428 | John Nathan Seppo | Social Worker | 3847 Pine Grove Avenue, Fort Gratiot, MI 48059 | 2006-08-19 |
| 1720018823 | Minden City Community Healthcare Outreach | Clinic/Center | 28 Deer Creek Drive, Fort Gratiot, MI 48059 | 2006-07-04 |
| 1982103966 | Luke Michael Privette | Physical Therapist | 4351 24th Ave Ste 1, Fort Gratiot, MI 48059 | 2018-02-06 |
| 1194115352 | Rachel Brooks | Chiropractor | 2844 Krafft Rd, Fort Gratiot, MI 48059 | 2015-01-27 |
| 1063697506 | C & T Enterpirses, Inc. | Optometrist | 3957 24th Ave, Fort Gratiot, MI 48059 | 2008-01-03 |
| Find all providers in zip 48059 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922415223 | Talia Marie Shackelford | Dentist | 4216 24th Ave, Fort Gratiot, MI 48059-3880 | 2014-07-18 |
| 1356811756 | Michigan Restorative Institute, Pllc | Dentist | 4036 24th Ave, Fort Gratiot, MI 48059-3800 | 2018-11-28 |
| 1184005852 | Mary Darghali | Dentist | 4216 24th Ave, Fort Gratiot, MI 48059-3880 | 2015-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700986 | Lake Orion Family Dentistry | Dentist | 1320 S Lapeer Rd, Lake Orion, MI 48360-1435 | 2020-11-05 |
| 1093315202 | Peninsula Family Dentistry, PC | Dentist | 3210 Us 41 W, Marquette, MI 49855-9483 | 2020-10-27 |
| 1437758398 | Pristine Dental Care | Dentist | 3021 E Walton Blvd, Auburn Hills, MI 48326-2368 | 2020-10-21 |
| 1003414749 | Rami Ghandour | Dentist | G3023 Miller Rd, Flint, MI 48507-1353 | 2020-10-14 |
| 1013514538 | Ranim Suliman | Dentist | 9824 Conant St, Hamtramck, MI 48212 | 2020-10-07 |
| 1457968133 | Norman Family Dentistry PC | Dentist | 519 Ada Dr Se Ste A, Ada, MI 49301-9069 | 2020-09-28 |
| 1992312680 | Waely Dental Pllc | Dentist | 1769 Inkster Rd, Garden City, MI 48135-3028 | 2020-09-26 |
| 1164037362 | David Posada | Dentist | 1326 Marion Ave, Lincoln Park, MI 48146-2090 | 2020-09-14 |
| 1144835059 | Chelsea Anthony | Dentist | 23207 Norcrest Dr, Saint Clair Shores, MI 48080-2586 | 2020-09-09 |
| 1275147399 | Yuvraj Pannu | Dentist | 2501 W Pierson Rd Unit B, Flint, MI 48504-6802 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | FORT GRATIOT |
| Zip Code | 48059 |
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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.