Healthcare Provider Details

I. General information

NPI: 1386509131
Provider Name (Legal Business Name): COVARRUBIAS FAMILY DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 W DICKMAN RD
SPRINGFIELD MI
49037-7964
US

IV. Provider business mailing address

11199 3 1/2 MILE RD
BATTLE CREEK MI
49015-9370
US

V. Phone/Fax

Practice location:
  • Phone: 269-962-1536
  • Fax:
Mailing address:
  • Phone: 269-274-7616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MYRA IVETTE COVARRUBIAS
Title or Position: DENTIST
Credential: DDS
Phone: 269-962-1536