Steven M Dater, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

15026 Issued in MI

Practice address

170 Marcell Dr NE
Suite #a
Rockford, MI 49341-1300

Phone

(616) 884-5767

Fax

(616) 884-5789

NPI assigned

May 23, 2007

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1023228509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MARCELL DR NE",
            "address_2": "SUITE #A",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411300",
            "telephone_number": "616-884-5767",
            "fax_number": "616-884-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MARCELL DR NE",
            "address_2": "SUITE #A",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411300",
            "telephone_number": "616-884-5767",
            "fax_number": "616-884-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATER",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "15026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Rockford, MI
• Providers in Rockford, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.