MICHIGAN CITY FAMILY DENTISTRY


Address: 6044 Lute Rd, Portage, IN 46368-5008
Phone: 2197644004

MICHIGAN CITY FAMILY DENTISTRY (NPI# 1417150137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417150137
Entity Type Organization
Organization Name MICHIGAN CITY FAMILY DENTISTRY
Other Organization Name PORTAGE DENTAL REHAB CENTER
Practice Address 6044 Lute Rd
Portage
IN 46368-5008
Practice Telephone 2197644004
Practice Fax Number 2197644031
Mailing Telephone 2197644004
Mailing Fax Number 2197644031
Enumeration Date 2007-06-08
Last Update Date 2020-08-22
Authorized Official Name DR. CRESHINDA DENISE AYANGADE (DENTIST)
Authorized Official Telephone 2197644004
Authorized Official Credential DMD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
X 122300000X Dentist Dental Providers
X 1223P0300X Dentist
Specialization: Periodontics
Dental Providers

Other Provider/Organization Names

Other Name Type Code
Portage Dental Rehab Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1124221833 Michigan City Family Dentistry Dentist 332 Dunes Plz, Michigan City, IN 46360-7342 2007-06-08

Office Location

Street Address 6044 LUTE RD
City PORTAGE
State IN
Zip Code 46368-5008

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366041121 Latresa Renee Sims Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1777 Armstrong St. Suite C., Portage, IN 46368 2020-10-22
1831576693 Bishara Robert Khoury Family Medicine 3545 Arbor Blvd Ste E, Portage, IN 46368 2015-04-30
1962813535 Diane Farrington Pharmacist 6050 Us Hwy 6, Portage, IN 46368 2014-05-16
1588827562 Jennifer Ann Rumpel Allergy & Immunology 6375 Us Highway 6 Ste C, Portage, IN 46368 2008-07-09
1588822688 Total Renal Care Inc Clinic/Center 5823 Us Highway 6, Portage, IN 46368 2008-05-27
1235321480 Michael Wendahl Physical Therapist 3691 Willowcreek Road, Suite 100, Portage, IN 46368 2007-08-13
1679663603 Stephen V Headley Family Medicine 3283 Willowcreek Rd, Portage, IN 46368 2006-10-13
1730276486 Robert Tan Ang Psychiatry & Neurology 3156 Willowcreek Road, Portage, IN 46368 2006-10-06
1013029883 Primary Care PC Family Medicine 3125 Willowcreek Road, Portage, IN 46368 2006-08-31
1104936962 Margaret Eileen Griffith Dentist 2646 Lois Street, Portage, IN 46368 2006-08-30
Find all providers in zip 46368

Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205452562 Bradford and Rowean Dds PC Dentist 710 W Centre Ave, Portage, MI 49024-5310 2020-06-23
1427509769 Hammond Dental Group LLC Dentist 3109 Willowcreek Rd, Portage, IN 46368-4423 2016-10-21
1952737538 Merit Dental Michigan PC Dentist 3060 W Centre Ave Ofc B, Portage, MI 49024-4825 2013-09-16
1306142815 Jody Lynn Wrathall Dentist 3020 Old Centre Rd, Portage, MI 49024 2011-01-31
1124350764 Pei Wei Linda Lin Dmd Pllc Dentist 6714 S Westnedge Ave, Portage, MI 49002-3538 2010-02-08
1407098056 Robert S Yeung Dentist 950 Trade Centre Way, Suite 225, Portage, MI 49002-0487 2009-03-28
1700042165 Aoua Coulibaly Dentist 5200 S Westnedge Ave, Portage, MI 49002-0405 2008-08-05
1700045523 Thomas Kwong Dentist 5907 Oakland Dr, Portage, MI 49024-1120 2008-06-06
1902076268 Daniel John Brayton Dentist 470 W Centre Ave, Suite B, Portage, MI 49024-5362 2008-03-03
1598976144 Susan M. Dennis, D.d.s. Dentist 8150 Moors Bridge Rd, Suite A, Portage, MI 49024-7419 2007-05-25
Find all providers in PORTAGE

Competitor

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City PORTAGE
Zip Code 46368

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Dataset Information

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.

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