Individual provider Active NPI

James J Osetek, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Petoskey, MI
National Provider Identifier
1003892944
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
JO013255 Issued in MI
Practice address
322 Bay St
Suite 2
Petoskey, MI 49770-2489
Phone
(231) 347-1601
Fax
(231) 347-0330
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X JO013255 MI Primary

Addresses

Primary practice location

322 Bay St
Suite 2
Petoskey, MI 49770-2489

Mailing address

322 Bay St
Suite 2
Petoskey, MI 49770-2489
Phone (231) 347-1601

Other identifiers 7

IdentifierTypeStateIssuer
JO013255OtherMIDENTAL LICENSE
1154483014OtherNPI ORGANIZATION
2773425MedicaidMI
2773434MedicaidMI
3020517MedicaidMI
0B46032OtherMIBCBSM PROVIDER ID
3020526MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
JO013255MIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Monarch Family Chiropractic LLC PastSince May 1, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1003892944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 BAY ST",
            "address_2": "SUITE 2",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702489",
            "telephone_number": "231-347-1601",
            "fax_number": "231-347-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 BAY ST",
            "address_2": "SUITE 2",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702489",
            "telephone_number": "231-347-1601",
            "fax_number": "231-347-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSETEK",
        "first_name": "JAMES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "JO013255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "JO013255",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI ORGANIZATION",
            "identifier": "1154483014",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2773425",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2773434",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020517",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PROVIDER ID",
            "identifier": "0B46032",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020526",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.