GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS – NPI #1508126517
Clinic/Center

GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS is an AHC clinic located in PESHAWBESTOWN, MI. NPPES has assigned the NPI number 1508126517 to GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS on May 23, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS is also known by the name GTB DENTAL CLINC. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was previously updated about 13 years ago on Dec 04, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS below.

NPI Profile for
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS

NPI Number
1508126517
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GRAND TRAVERSE BAND OF OTTAWA AND CHIPPEWA INDIANS
Other Name: GTB DENTAL CLINC
Primary location
2300 N STALLMAN ROAD
PESHAWBESTOWN, MI 49682
Phone: (231) 534-7211 Fax: (231) 534-7460
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
LORI CHAMBERS
MANAGER
Phone: (231) 534-7477
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)		 MI 261QD0000X

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.