Active NPI
James J Osetek, DMD
- Oral and Maxillofacial Surgery (Dentist)
- Petoskey, MI
National Provider Identifier
1003892944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- JO013255
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| JO013255 | Other | MI | DENTAL LICENSE |
| 1154483014 | Other | NPI ORGANIZATION | |
| 2773425 | Medicaid | MI | |
| 2773434 | Medicaid | MI | |
| 3020517 | Medicaid | MI | |
| 0B46032 | Other | MI | BCBSM PROVIDER ID |
| 3020526 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| JO013255 | MI | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monarch Family Chiropractic LLC | Past | 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.
-
- Clinic/Center
- East Jordan, MI
- NPI 1831663475
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.