1. Home
  2. Directory
  3. Michigan
  4. Portage
  5. Clinic Center
  6. NPI Profile

PORTAGE NORTHERN DENTAL
NPI 1295486512
Clinic/Center - Dental in Portage, MI

Active since January 18, 2022
1220 W MILHAM AVE, PORTAGE, MI 49024(269) 382-5040 Get Directions Write a Review

NPPES record last updated: January 18, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Portage Northern Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PORTAGE NORTHERN DENTAL (NPI 1295486512) is a healthcare organization registered as a dental in Portage, Michigan and active in the NPI registry since January 2022. The organization lists Renee Heise, Insurance Specialist, as its authorized official.

NPPES Registry Identity

NPI1295486512
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NamePORTAGE NORTHERN DENTAL
Location Address1220 W MILHAM AVEPortage, MI 49024-1206
Mailing Address1220 W Milham AvePortage, MI 49024-1206 · (269) 382-5040
Phone(269) 382-5040
Organization SubpartNo
Authorized OfficialRenee HeiseInsurance Specialist · (231) 246-2204
Enumeration DateJanuary 18, 2022
NPPES CertifiedJanuary 18, 2022
✔ NPI 1295486512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1220 W MILHAM AVE, Portage, MI 49024
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Portage Northern Dental's NPI number?

The NPI number for Portage Northern Dental is 1295486512. It was assigned to this organization in the NPPES registry on January 18, 2022.

Where is Portage Northern Dental located?

Portage Northern Dental is located at 1220 W Milham Ave, Portage, MI 49024. The listed phone number is (269) 382-5040.

What is Portage Northern Dental's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Portage Northern Dental was last updated on January 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.