Individual provider Active NPI

Gillian Edwards, D.D.S.

  • General Practice Dentistry
  • Saginaw, MI
National Provider Identifier
1063607000
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901014398 Issued in MI
Practice address
427 N Michigan Ave
Saginaw, MI 48602-4314
Phone
(989) 755-0991
Fax
(989) 755-0001
NPI assigned
Sep 12, 2007
Last updated
Jul 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901014398 MI Primary

Addresses

Primary practice location

427 N Michigan Ave
Saginaw, MI 48602-4314

Mailing address

427 N Michigan Ave
Saginaw, MI 48602-4314
Phone (989) 755-0991

Other identifiers 1

IdentifierTypeStateIssuer
124976113MedicaidMI

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
I20170630001458 MI Order and Referring Only - DentistPractitioner - Dentist 3375812530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901014398MIMDGeneral Practice Dentistry

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": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1063607000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 N MICHIGAN AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024314",
            "telephone_number": "989-755-0991",
            "fax_number": "989-755-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 N MICHIGAN AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024314",
            "telephone_number": "989-755-0991",
            "fax_number": "989-755-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "GILLIAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124976113",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.