Michael D Jennings, DENTIST

Primary specialty

DentistTaxonomy code 122300000X

License

11575 Issued in MI

Practice address

22601 Harper Ave
Suite 1003
Saint Clair Shores, MI 48080-1829

Phone

(586) 772-7393

NPI assigned

Jun 28, 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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IFADCA/Endpoint/IFADCA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wayne County Treasurer-Payroll County of Wayne

  • Federally Qualified Health Center (FQHC)
  • Hamtramck, MI
  • NPI 1700215977

  MI

  Medicare reassignment NPD
• Dr Michael D Jennings DDS PC

  • Dentist
  • St Clair Shores, MI
  • NPI 1053406736
  NPD (past) Authorized official
• Wayne County Treasurer Payroll-County of Wayne

  • Federally Qualified Health Center (FQHC)
  • Wayne, MI
  • NPI 1538543160
  NPD

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043417504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22601 HARPER AVE",
            "address_2": "SUITE 1003",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801829",
            "telephone_number": "586-772-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22601 HARPER AVE",
            "address_2": "SUITE 1003",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801829",
            "telephone_number": "586-772-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "11575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Degroat PHD PLLC
• Edward S. Jeffries, M.D.
• Jehan Wakeem DDS PLLC
• Devon Eileen Jennings, PA
• Melissa Jennings, M.D.
• Gray Jessiman, LLMSW
• Hanna Jetel, RD
• Jacob Jewell, FNP-C
• Hannah Emily Ranieri Jezak
• Jo Anne Levitan MD PC

• All providers in Saint Clair Shores, MI
• Dentist in Michigan

• 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.