Active NPI
Michael Todd Watkins, D.D.S.
- General Practice Dentistry
- Kent City, MI
National Provider Identifier
1043229917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901014777
- Practice address
- 52 S. Main St.
Suite a
Kent City, MI 49330 - Phone
- (616) 678-4040
- Fax
- (616) 678-5194
- NPI assigned
- Aug 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901014777 | MI | Primary |
Addresses
Primary practice location
52 S. Main St.
Suite a
Kent City, MI 49330
Mailing address
52 S. Main St.
P.O. Box 300
Kent City, MI 49330
Phone (616) 678-4040
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1825607 | Medicaid | MI | |
| 2901014777 | Other | MI | DENTAL LICENSE ID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeffrey B. Byland, O.D., P.C. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043229917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 S. MAIN ST.",
"address_2": "P.O. BOX 300",
"city": "KENT CITY",
"state": "MI",
"postal_code": "49330",
"telephone_number": "616-678-4040",
"fax_number": "616-678-5194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 S. MAIN ST.",
"address_2": "SUITE A",
"city": "KENT CITY",
"state": "MI",
"postal_code": "49330",
"telephone_number": "616-678-4040",
"fax_number": "616-678-5194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "MICHAEL",
"middle_name": "TODD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901014777",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1825607",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE ID NUMBER",
"identifier": "2901014777",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kent City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.