Provider Demographics
NPI:1285436113
Name:JM DENTAL GROUP PC
Entity type:Organization
Organization Name:JM DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING /INSURANCE/ CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PLIKERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-216-9298
Mailing Address - Street 1:17 VINEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-2375
Mailing Address - Country:US
Mailing Address - Phone:269-651-6700
Mailing Address - Fax:269-659-8604
Practice Address - Street 1:435 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MENDON
Practice Address - State:MI
Practice Address - Zip Code:49072-8744
Practice Address - Country:US
Practice Address - Phone:269-496-8484
Practice Address - Fax:269-659-8604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JM DENTAL GROUP, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-24
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty