Individual provider Active NPI

Joseph M Irmen, DDS

  • General Practice Dentistry
  • Midland, MI
National Provider Identifier
1003887555
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10143 Issued in MI
Practice address
4710 N Saginaw Rd
Midland, MI 48640-2310
Phone
(989) 631-0840
Fax
(989) 631-5350
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10143 MI Primary

Addresses

Primary practice location

4710 N Saginaw Rd
Midland, MI 48640-2310

Mailing address

4710 N Saginaw Rd
Midland, MI 48640-2310
Phone (989) 631-0840

Other identifiers 1

IdentifierTypeStateIssuer
2709818MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160204001348 MI Order and Referring Only - DentistPractitioner - Dentist 5092019471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10143MIMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003887555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 N SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402310",
            "telephone_number": "989-631-0840",
            "fax_number": "989-631-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 N SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402310",
            "telephone_number": "989-631-0840",
            "fax_number": "989-631-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRMEN",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "10143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2709818",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.