Provider Demographics
NPI:1922100338
Name:JOHN M DEE DDS PC
Entity Type:Organization
Organization Name:JOHN M DEE DDS PC
Other - Org Name:FREELAND FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-754-2171
Mailing Address - Street 1:301 E GENESEE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607
Mailing Address - Country:US
Mailing Address - Phone:989-754-2171
Mailing Address - Fax:989-752-3678
Practice Address - Street 1:301 E GENESEE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48607
Practice Address - Country:US
Practice Address - Phone:989-754-2171
Practice Address - Fax:989-752-3678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901017189122300000X
MI2901009533122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
9533OtherDELTA DENTAL
972463OtherUNITED CONCORDIA
2901017189OtherSTATE OF MI
MI4053067Medicaid
17189OtherDELTA DENTAL
2901009533OtherSTATE OF MI ID
MIMI9533OtherBCBS
MI3377900Medicaid
MIMI17189OtherBCBS
971414OtherUNITED CONCORDIA