Teresa Michaud, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22 DI01442900 Issued in NJ

Practice address

849 Lincoln Ave
Glen Rock, NJ 07452-3231

Phone

(201) 445-1166

Fax

(201) 445-3337

NPI assigned

Feb 16, 2007

Sex

Female

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 NJ

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043354657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 LINCOLN AVE",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523231",
            "telephone_number": "201-445-1166",
            "fax_number": "201-445-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 LINCOLN AVE",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523231",
            "telephone_number": "201-445-1166",
            "fax_number": "201-445-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAUD",
        "first_name": "TERESA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22 DI01442900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med-Surg Durables LLC
• Med-Surg Practitioners, LLC
• Medical Finance Resources, Inc.
• Melissa L. Bauch
• Kunal Yatish Merchant, M.D.
• Lisa Miraglia-Ranoff, RPH
• David A Mitnick, M.D.
• MMB Transportation Services, LLC
• Mayra Modesto-Garrido, D.D.S.
• Aryam Modesto, D.M.D.

• General Practice Dentistry in Glen Rock, NJ
• Providers in Glen Rock, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.

Verify at the official NPI Registry.