Michael Haddow, D.D.S.,M.S.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2901013270 Issued in MI

Practice address

28625 Southfield Rd
Lathrup Village, MI 48076-2701

Phone

(248) 569-2056

Fax

(248) 569-8987

NPI assigned

Apr 3, 2007

Last updated

Jun 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mhaddow1131003@direct.hfhs.org

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

• Lathrup Family Dentistry

  • General Practice Dentistry
  • Lathrup Village, MI
  • NPI 1235305301
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1013039098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28625 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762701",
            "telephone_number": "248-569-2056",
            "fax_number": "248-569-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28625 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762701",
            "telephone_number": "248-569-2056",
            "fax_number": "248-569-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOW",
        "first_name": "MICHAEL",
        "credential": "D.D.S.,M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "13270",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901013270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.