Individual provider Active NPI

Alexander Scott Todd

  • Dentist
  • Detroit, MI
National Provider Identifier
1053183541
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901602216 Issued in MI
Practice address
5716 Michigan Ave
Detroit, MI 48210-3039
Phone
(313) 554-3880
NPI assigned
Oct 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901602216 MI Primary

Addresses

Primary practice location

5716 Michigan Ave
Detroit, MI 48210-3039

Mailing address

5716 Michigan Ave
Detroit, MI 48210-3039

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
I20250616002868 MI Order and Referring Only - DentistPractitioner - Dentist 2961913058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901602216MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1053183541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103039",
            "telephone_number": "313-554-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "ALEXANDER",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-26",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.