GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS (NPI# 1508126517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508126517 |
| Entity Type | Organization |
| Organization Name | GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS |
| Other Organization Name | GTB DENTAL CLINC |
| Practice Address |
2300 N Stallman Road Peshawbestown MI 49682 |
| Mailing Address |
2300 N Stallman Road Suite A Peshawbestown MI 49682 |
| Practice Telephone | 2315347211 |
| Practice Fax Number | 2315347460 |
| Mailing Telephone | 2315347211 |
| Mailing Fax Number | 2315347460 |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2013-12-04 |
| Authorized Official Name | MS. LORI E CHAMBERS (MANAGER) |
| Authorized Official Telephone | 2315347477 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
261QD0000X | MI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| GTB Dental Clinc | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134281132 | Grand Traverse Band of Ottawa and Chippewa Indians | Clinic/Center | 2300 N Stallman Rd, Suttons Bay, MI 49682-9158 | 2006-12-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS | 2605 N West Bay Shore Dr, Peshawbestown, MI 49682-9275 |
| Street Address |
2300 N STALLMAN ROAD |
| City | PESHAWBESTOWN |
| State | MI |
| Zip Code | 49682 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154735850 | Samantha J Haken | Family Medicine | 2300 N Stallman Road, Suite A, Peshawbestown, MI 49682 | 2014-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558913251 | Baybrooke Counseling | General Practice | 421 St. Josephs Ave, Suttons Bay, MI 49682 | 2019-07-12 |
| 1942756259 | Aleeah Bebermeyer | Physical Therapy Assistant | 73 W Fourth St., Sutton Bay, MI 49682 | 2016-08-28 |
| 1619346780 | Kathy Ann Bowers | Registered Nurse | 2300 N. Stallman Rd, Suttons Bay, MI 49682 | 2015-09-18 |
| 1063648491 | John Allen Nagel | Pharmacist | 321 N.st.joseph, Suttons Bay, MI 49682 | 2009-05-29 |
| 1205953395 | Mark Hall Hoffman | Chiropractor | 111 Madison St, Suttons Bay, MI 49682 | 2007-03-23 |
| 1104957109 | Lise C. Zahn | Physical Therapist | 73 Fourth St., Suttons Bay, MI 49682 | 2007-03-08 |
| 1457481251 | Andrea Darlene Xaver | Pharmacist | 321 N. St. Joseph St., Suttons Bay, MI 49682 | 2007-03-07 |
| 1871643858 | Steven David Hall | Dentist | 1299 Southwest Bay Shore Drive, Suttons Bay, MI 49682 | 2007-01-11 |
| 1457441362 | Donald R Mileski | Pharmacist | 321 N Saint Joseph St, Suttons Bay, MI 49682 | 2006-10-13 |
| 1255420147 | Terrance David Zawora | Pharmacist | 321b N Saint Joseph, Suttons Bay, MI 49682 | 2006-10-11 |
| Find all providers in zip 49682 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821216 | Inspired Family Dental Care | Clinic/Center | 1685 Fairholme Rd, Grosse Pointe Woods, MI 48236-2368 | 2020-11-05 |
| 1376144261 | Right Choice Dental, PC | Clinic/Center | 475 Columbia Ave E Ste 5, Battle Creek, MI 49014-5461 | 2020-11-05 |
| 1669073813 | Thomas M Smith, Dds, Plc | Clinic/Center | 755 Seminole Rd Ste 103, Norton Shores, MI 49441-6561 | 2020-11-04 |
| 1235739533 | Randy J Breen Dds Pllc | Clinic/Center | 2460 Burton St Se Ste 201, Grand Rapids, MI 49546-4800 | 2020-10-27 |
| 1831798370 | Saline Dental Care, Pllc | Clinic/Center | 150 Judd Rd, Milan, MI 48160-9584 | 2020-10-24 |
| 1235738113 | David Sorial Dds PC | Clinic/Center | 14755 Northline Rd, Southgate, MI 48195-2407 | 2020-10-21 |
| 1598363970 | Steven M Moss Dds PC | Clinic/Center | 37625 Ann Arbor Rd Ste 108, Livonia, MI 48150-2400 | 2020-10-16 |
| 1700484375 | Troy Cosmetic and Implant Dental Center Pllc | Clinic/Center | 4770 Rochester Rd Ste 106, Troy, MI 48085-4951 | 2020-10-15 |
| 1194323303 | Aq Dental Group Pllc | Clinic/Center | 10413 Ford Road, Units M & N, Dearborn, MI 48126 | 2020-10-12 |
| 1245837806 | Kendall J Lee Dds Pllc | Clinic/Center | 111 S Howell St, Hillsdale, MI 49242-1873 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
| City | PESHAWBESTOWN |
| Zip Code | 49682 |
Please comment or provide details below to improve the information on GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS.
| 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.