GREAT LAKES ENDODONTICS (NPI# 1659802395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659802395 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES ENDODONTICS |
| Practice Address |
950 Trade Centre Way Ste 225 Portage MI 49002-0487 |
| Practice Telephone | 2693492189 |
| Mailing Telephone | 2693492189 |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |
| Authorized Official Name | DR. ROBERT YEUNG (OWNER) |
| Authorized Official Telephone | 2693492189 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
2901019963 | MI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104255371 | Great Lakes Endodontics | Clinic/Center | 4815 W Arrowhead Rd, Hermantown, MN 55811-4004 | 2013-11-07 |
| Street Address |
950 TRADE CENTRE WAY STE 225 |
| City | PORTAGE |
| State | MI |
| Zip Code | 49002-0487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407098056 | Robert S Yeung | Dentist | 950 Trade Centre Way, Suite 225, Portage, MI 49002-0487 | 2009-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604204 | Susan Vandewalker | Physical Therapist | 8001 Angling Rd., Portage, MI 49002 | 2018-03-28 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1386045383 | Pinnacle Senior Care of Kalamazoo, LLC | Home Health | 2725 Airview Blvd Ste 105b, Portage, MI 49002 | 2014-09-09 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1619211919 | Daketia L Thomas | Massage Therapist | 8314 Portage Rd, Suite D, Kalamazoo, MI 49002 | 2012-11-27 |
| 1831457142 | Kinetic Kids, LLC | Occupational Therapist | 540 East Milham, Portage, MI 49002 | 2012-04-25 |
| 1154689404 | Lauren Michelle Mattaliano | Occupational Therapist | 540 E. Milham Road, Portage, MI 49002 | 2012-04-24 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
| Find all providers in zip 49002 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134233943 | Dan J Vandermeulen Dds Ms & Ronald W Reoch Dds Ms PC | Dentist | 8191 Moorsbridge Rd, Ste A, Portage, MI 49024 | 2006-08-18 |
| 1659485464 | Dan J Vandermeulen | Dentist | 8191 Moorsbridge Road, Suite A, Portage, MI 49024 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1285252874 | Plymouth Endodontics | Dentist | 9416 S Main St Ste 212, Plymouth, MI 48170-4148 | 2020-07-09 |
| 1578192712 | Rabban-acho Dental Pllc | Dentist | 38550 Garfield Rd Ste C, Clinton Township, MI 48038-3406 | 2020-04-08 |
| 1700411378 | Macomb Endodontics | Dentist | 51817 Gratiot Ave, Chesterfield, MI 48051-2014 | 2020-03-04 |
| 1861950701 | Garfield Road Dental- 2 | Dentist | 15401 Dix Toledo Rd, Southgate, MI 48195-2662 | 2019-03-11 |
| 1336654102 | Elite Endodontics | Dentist | 1135 S Lapeer Rd Ste A, Lake Orion, MI 48360-1432 | 2017-12-02 |
| 1255719456 | Norton Shores Dental PC | Dentist | 837 Seminole Rd Ste 100, Norton Shores, MI 49441-6734 | 2015-05-08 |
| 1396186292 | Ryan Brooks Mcmahan | Dentist | 400 W Main St Ste 106, Gaylord, MI 49735-1870 | 2013-07-09 |
| 1124461579 | Sarmad Mazin Alyas | Dentist | 37641 Pembroke Ave, Livonia, MI 48152-1050 | 2013-04-16 |
| 1568704468 | Arnold Harry Gartner | Dentist | 1547 W Long Lake Rd, Bloomfield Hills, MI 48302-1342 | 2013-03-19 |
| Find all providers with the same taxonomy | ||||
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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.