Individual provider Active NPI

Sandeep Sood, D.D.S

  • Dentist
  • Holt, MI
National Provider Identifier
1043535982
Registry record updated Dec 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901017508 Issued in MI
Practice address
2205 Cedar St
Holt, MI 48842-1203
Phone
(517) 694-2501
Fax
(517) 694-2637
NPI assigned
Apr 4, 2010
Last updated
Dec 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901017508 MI Primary
General Practice Dentistry 1223G0001X 2901017508 MI

Addresses

Primary practice location

2205 Cedar St
Holt, MI 48842-1203

Mailing address

2205 Cedar St
Holt, MI 48842-1203
Phone (517) 694-2501

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161220001686 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0143501726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sandeep Sood D.D.S. P.C. Dentist CurrentSince Jul 10, 2002 Accepting new patients

Locations

2205 Cedar St
Holt, MI 48842
Phone (517) 694-2501

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": "1270339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482019200000",
    "number": "1043535982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 CEDAR ST",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421203",
            "telephone_number": "517-694-2501",
            "fax_number": "517-694-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 CEDAR ST",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421203",
            "telephone_number": "517-694-2501",
            "fax_number": "517-694-2637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOD",
        "first_name": "SANDEEP",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-04",
        "last_updated": "2016-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901017508",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017508",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holt, MI

Sources for this page

Verify at the official NPI Registry.