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Fluoride Varnish Certificates for Medicaid Professionals

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Fluoride Varnish Certificates for Medicaid Professionals December 8, 2017 Michigan Department of Health and Human Services Page 1 of 34 Fluoride Varnish Training Certificates for Medicaid Professionals County: Name: Title: Provider NPI: Agency: Address: Allegan Rik Tooker MD 1154385672 Allegan County Health Dept 3255 122nd Ave. Ste 200 Allegan, MI 49010 Allegan Cassie Plockmeyer NP 1518385129 Allegan Professional Health Services 551 Linn Street Allegan, MI 49010 Allegan Sara Franzen MD 1871735522 Allegan Professional Health Services 551 Linn Street Allegan, MI 49010 Allegan William Davis MD 1629130703 Allegan Professional Health Services 551 Linn Street Allegan, MI 49010 Allegan Tom Saad waiting on cert from MD 1417908930 Borgess Family Medicine & Pediatrics 345 Naomi Street Plainwell, MI 49080 Altarum Allegan, Ottawa Allison Rund MD 1164685608 Spectrum Health Med Group- Holland 588 E. Lakewood Blvd. Holland, MI 49424 Allegan, Ottawa Erin Michelle Walton CPNP-PC, 1669847703 Spectrum Health Med Group- Holland 588 E. Lakewood Blvd. Holland, MI 49424 BSN, RN Allegan, Ottawa Nancy MacDonald MD 1114960150 Spectrum Health Med Group- Holland 588 E. Lakewood Blvd. Holland, MI 49424 Allegan, Ottawa Wendy Pytlak Zink DO 1760450928 Spectrum Health Med Group- Holland 588 E. Lakewood Blvd. Holland, MI 49424 Alpena Christy Werth DO 1750390498 Alpena Medical Arts, P.C. 211 Long Rapids Rd. Alpena, MI 49707 Alpena James Decker MD 1497749576 Alpena Medical Arts, P.C. 211 Long Rapids Rd. Alpena, MI 49707 Alpena Kathleen Phillips NP 1497099667 Alpena Medical Arts, P.C. 211 Long Rapids Rd. Alpena, MI 49707 Alpena Rong Lawson MD 1215116025 Alpena Medical Arts, P.C. 211 Long Rapids Rd. Alpena, MI 49707 Antrim Albert Brown MD 1174516744 Mancelona Family Practice 419 W. State St. Mancelona, MI 49659 Antrim Jennifer Leino MD 1588648539 Mancelona Family Practice 419 W. State St. Mancelona, MI 49659 Arenac Brodi Lynch MD 1285958223 Standish Family Medicine 805 W. Cedar Standish, MI 48658 Arenac Ceaser Casten MD 1962440511 Standish Family Medicine 805 W. Cedar Standish, MI 48658 Baraga Sharon Gilliland MD 1669479390 BCMH Physician Group 18341 US Hwy 41 L'Anse, MI 49946 Barry David Halley MD Borgess Family Medicine 345 Naomi St Plainwell MI 49080 Barry Nehdia Hashemi MD 1295014124 Borgess Family Medicine 345 Naomi St Plainwell MI 49080 Barry Thomas Akland DO 1205873056 Borgess Health- Family Medicine and Pediatrics 345 Naomi St Plainwell MI 49080 Barry Amy Beck MD 1740244144 Bright Start Pediatrics 1375 W. Green St. Hastings, MI 49058 Barry Amanda Rathburn FNP-BC 1750716593 Ingham Well Child 901 E. Mt. Hope Rd. Lansing, MI 48910 Bay Bhaskar Devanagondi MD 1386704419 Bay Pediatric Clinic 2110 16th Street Bay City, MI 48708 Bay Bilugali Sundara MD 1437219540 Bay Pediatric Clinic 2110 16th Street Bay City, MI 48708 Bay Inez Balinska 1831171230 Bay Regional Pediatrics 1456 W. Center Rd. Suite 1 Essexville, MI 48732 Bay Donna Hammond NP 1366438996 Children's Medical Group of Saginaw Bay-Bay City 248 Washington Ave. Bay City, MI 48708 Bay Jeffrey VanGelderen MD 1043217979 Children's Medical Group of Saginaw Bay-Bay City 248 Washington Ave. Bay City, MI 48708 Bay Ariadne Lie MD 1245243484 GLBHC-Bayside 3884 Monitor Road Bay City, MI 48706 Bay Barbara Kish NP 1902894769 GLBHC-Bayside 3884 Monitor Road Bay City, MI 48706 Bay Gary Tamez DO 1265422356 GLBHC-Bayside 3884 Monitor Road Bay City, MI 48706 Bay Heather Prior NP 1821377748 GLBHC-Bayside 3884 Monitor Road Bay City, MI 48706 Bay Kristie Smith NP 1700339249 GLBHC-Bayside 3884 Monitor Road Bay City, MI 48706 Bay Alexandria M. Smits DO 1104230358 McLaren Bay Family Health & Wellness Center 1458 W. Center Road, Suite 5 Essexville, MI 48732 Bay Andrew A. Whiteside DO 1710330634 McLaren Bay Family Health & Wellness Center 1458 W. Center Road, Suite 5 Essexville, MI 48732 Bay Dustin James DO 1952857872 McLaren Bay Family Health & Wellness Center 1458 W. Center Road, Suite 5 Essexville, MI 48732 Bay Jessica Neuroth DO 1487036513 McLaren Bay Family Health & Wellness Center 1458 W. Center Road, Suite 5 Essexville, MI 48732 Bay Maria Lawrence DO 1942263801 McLaren Bay Family Health & Wellness Center 1458 W. Center Road, Suite 5 Essexville, MI 48732 Bay Marilyn Nguyen DO 1457704371 McLaren Bay Family Health & Wellness Center 1458 W. Center Road, Suite 5 Essexville, MI 48732 Bay Suhaylah Mohiuddin DO 1710369830 McLaren Bay Family Health & Wellness Center 1458 W. Center Road, Suite 5 Essexville, MI 48732 Bay Darius Balinski 1891777892 McLaren Bay Region 1456 W. Center Rd. Suite 1 Essexville, MI 48732 Bay MaryAnne Putt NP 1992859250 McLaren Bay Region - Auburn Family Medicine 312 E. Midland Rd. Auburn, MI 48611 Bay Stacey Williamson NP 1548528086 Pinconning Family Medicine 204 W. 3rd St. Pinconning, MI 48650 Benzie Jennifer Dankers NP 1477820983 Crystal Lake Health Clinic Benzonia 6227 Frankfort Hwy. Benzonia, MI 49616 Berrien Dr. Barbara Boyd MD 1417981549 Intercare Community Health Network 960 Agard St. Benton Harbor, 49022 December 8, 2017 Michigan Department of Health and Human Services Page 2 of 34 Fluoride Varnish Training Certificates for Medicaid Professionals County: Name: Title: Provider NPI: Agency: Address: Branch Mehalai Arivoli MD 1346274891 Branch Pediatric and Adolescent Medicine 360 East Chicago St. Suite 101 Coldwater, MI 49036 Branch Arivoli Veerappan MD 1306873658 CHC Pedicatrics 391 Northshore Dr. Coldwater, MI 49036 Branch H Lauren Vogel DO 1396770020 Family Medicine Clinic 292 E. Chicago St. Coldwater 49036 Branch Srijaya Bandi MD 1295907525 Family Medicine Clinic 292 East Chicago St. Suite 200 Coldwater 49036 Branch William K Stewart MD 1033147863 Family Medicine Clinic 292 E. Chicago St. Coldwater 49036 Calhoun David M. Byrens MD 1902874126 David M. Byrens, MD 215 E. Mansion St, Ste 1G Marshall, MI 49068 Calhoun Elizabeth Mettler MD 1215139449 Grace Health 181 W. Emmett St. Battle Creek, MI 49037-2963 Calhoun Emilie Rabb RN, CPNP 1851763668 Grace Health 181 W. Emmett St. Battle Creek, MI 49037-2963 Calhoun Karen Garcia DO 1891954400 Grace Health 181 W. Emmett St. Battle Creek, MI 49037-2963 Calhoun Kelli Collins DO 1598056251 Grace Health 181 W. Emmett St. Battle Creek, MI 49037-2963 Calhoun Linda Wetherbee RN, CPNP 1982666350 Grace Health 181 W. Emmett St. Battle Creek, MI 49037-2963 Calhoun Mark Richardson MD 1669449443 Mark D. Richardson MD PC 215 E. Mansion St, Ste 1G Marshall, MI 49068 Calhoun Jaime Viers NP 1568878452 Northside Pediatrics 265 Fremont St, #1 Battle Creek, MI 49017 Calhoun Jose R. Ayola MD 1265491831 Northside Pediatrics 265 Fremont St, #1 Battle Creek, MI 49017 Calhoun Krystyna B. Malec MD 1295794915 Northside Pediatrics 265 Fremont St, #1 Battle Creek, MI 49017 Charlevoix Roderic Tinney MD 1538151212 Munson Health Care Charlevoix Pediatrics 14719 W. Upright St. Charlevoix, MI 49720 Charlevoix Benjamin Edwards MD 1548606916 Munson Health Care Charlevoix Primary Care 14734 Park Ave. Charlevoix, MI 49720 Charlevoix Chris Loewen MD 1114368321 Munson Health Care Charlevoix Primary Care 14734 Park Ave. Charlevoix, MI 49720 Charlevoix Jean Mcdonough NP 1295035244 Munson Health Care Charlevoix Primary Care 14734 Park Ave. Charlevoix, MI 49720 Cheboygan Cathy Nowka NP 1902988777 Mackinac Straits Health System-Mackinaw City Medical 420 South Nicolet Street Mackinaw City, MI 49701 Clinic Cheboygan Roderick Baltzer DO 1760564041 Mackinac Straits Health System-Mackinaw City Medical 420 South Nicolet Street Mackinaw City, MI 49701 Clinic Chippewa Joseph Garlinghouse MD 1649219932 Chippewa Co Health Dept 508 Ashmun St. Suite 120, Sault Saint, MI 49783 Crawford Kristie H. Koehler MD 1174856785 Munson Health Care Grayling Hospital 1250 E. Michigan Avenue Grayling, MI 49738 Eaton Anne Khol NP 1770791246 Eaton Rapids Medical Center and Family Practice 1500 South Main Street Eaton Rapids, MI 48827 Eaton Harshini Jayasuriya MD 1043507833 Eaton Rapids Medical Center and Family Practice 1500 South Main Street Eaton Rapids, MI 48827 Eaton Julie Coenen NP 1053424150 Family Care Specialists 111 Lansing Street Eaton Todd Otten MD 1710967930 Family Care Specialists 111 Lansing Street Eaton Linda Murray Chermak MD 1619209442 Hayes Green Beach Health (HGB) 111 Lansing St. Suite 230 Charlotte, MI 48813 Eaton Stephanie Kramer NP 1518399484 Hayes Green Beach Health (HGB) 111 Lansing St. Suite 230 Charlotte, MI 48813 Eaton Jennifer Boote DO 1518129527 MSU Westside Pediatrics 7335 Westshire Drive Lansing, MI 48917 Eaton Joel Greenberg DO 1194838581 MSU Westside Pediatrics 7335 Westshire Drive Lansing, MI 48917 Eaton Robert Root DO 1043472665 MSU Westside Pediatrics 7335 Westshire Drive Lansing, MI 48917 Emmet Joshua Meyerson MD 1851383533 Little Traverse Bay Band Health Clinic 1250 Lears Road Petoskey, MI 49770 Genesee MUSTAFA GOKAY AKPINAR MD 1497703722 Akpinar Children's Clinic PC 2303 Stonebridge Dr. Bldg A Flint, MI 48532 Genesee Shivani Choudhary MD 1316130172 All Star Pediatrics 8203 S. Saginaw St Grand Blanc, MI 48439 Genesee Kamal Hasan MD 1427150168 Davison Pediatrics 1260 N. Irish Road, Suite A Flint, MI 48423 Genesee Elnahdl Saeed MD 1841216546 E. Saeed MD PC 2 Hurley Plaza, Suite 108 Flint, MI 48503 Genesee Luisa Schlaud NP 1780991877 E. Saeed MD PC 2 Hurley Plaza, Suite 108 Flint, MI 48503 Genesee Milton Holloway MD 1588615660 Flint Children's Center 5205 Norko Drive Flint, MI 48507 Genesee Rajalakshmi Sankaran MD 1124130299 Flint Children's Center 5205 Norko Drive Flint, MI 48507 Genesee Sudha Damidi MD 1407902869 Flint Children's Center 5205 Norko Drive Flint, MI 48507 Genesee Vina Patel MD 1639120660 Flint Children's Center 5205 Norko Drive
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