William Robert Desjardins III, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

L1355764 Issued in MI

Practice address

101 Maple Ridge Dr
East Jordan, MI 49727-8926

Phone

(231) 536-2601

Fax

(231) 536-2909

NPI assigned

Jul 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1013172071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAPLE RIDGE DR",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497278926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAPLE RIDGE DR",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497278926",
            "telephone_number": "231-536-2601",
            "fax_number": "231-536-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDINS",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "L1355764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Sue Cronin, LLMSW
• Adolph Cwik, MA, CRC, CCM, LBSW,
• Daniel J Thomas DC
• Delicate Doula Services LLC
• Amy Lynn Depinto, NP
• Detroit Bio Medical Laboratories,Inc
• Larry C Dittmar
• Joseph Peter Doyle III
• Samuel G Dyste, P.A.
• East Jordan Family Health Center

• Dentist in East Jordan, MI
• Providers in East Jordan, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.