Bruce Donigan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12986 Issued in MI

Practice address

3011 W. Grand Blvd.
Suite 862
Detroit, MI 48202-3012

Phone

(313) 871-1100

Fax

(313) 871-5376

NPI assigned

Jan 19, 2006

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

Other identifiers 1

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1013997725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 W. GRAND BLVD.",
            "address_2": "SUITE 862",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023012",
            "telephone_number": "313-871-1100",
            "fax_number": "313-871-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 W. GRAND BLVD.",
            "address_2": "SUITE 862",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023012",
            "telephone_number": "313-871-1100",
            "fax_number": "313-871-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONIGAN",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1860141",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherrell Donaldson
• Violeta Antonette Donawa
• Donegroup Ministries
• Cherise Lachelle Donelson
• Gauthier Tiolo Dongmo, MD
• Deborah Rose Donison, PH.D.
• Lydia Joy Donoghue, MD
• Lynn M Donohue, MD
• Danisha Danai Dooley
• Elijah Dooley, LPN

• General Practice Dentistry in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.