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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 122300000X | Dentist | Dental Providers | ||
X | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
Other Name | Type Code |
---|---|
Portage Dental Rehab Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124221833 | Michigan City Family Dentistry | Dentist | 332 Dunes Plz, Michigan City, IN 46360-7342 | 2007-06-08 |
Street Address |
6044 LUTE RD |
City | PORTAGE |
State | IN |
Zip Code | 46368-5008 |
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 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 |
---|---|---|---|---|
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 |
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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.