Individual provider Active NPI

Margo Yellin Woll, DDS

  • Dentist
  • Farmington Hills, MI
National Provider Identifier
1073543476
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901011880 Issued in MI
Practice address
25882 Orchard Lake Rd
Suite 105
Farmington Hills, MI 48336-9822
Phone
(888) 833-8441
Fax
(888) 330-4331
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901011880 MI Primary
Dentist 122300000X 052549 NY
Dentist 122300000X DS036752 PA
Dentist 122300000X 21530 MA
Dentist 122300000X 009567 CT
Dentist 122300000X DEN1000521 DC
Dentist 122300000X DEN02922 RI
Dentist 122300000X 016-0002216 VT
Dentist 122300000X DI02315900 NJ
Dentist 122300000X 03530 NH
Dentist 122300000X 13642 MD
Dentist 122300000X 60412 KS
Dentist 122300000X IL

Addresses

Primary practice location

25882 Orchard Lake Rd
Suite 105
Farmington Hills, MI 48336-9822

Mailing address

3311 Woodview Lake Rd
West Bloomfield, MI 48323-3573
Phone (248) 626-0459

Other identifiers 1

IdentifierTypeStateIssuer
3413200MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
009567CTMDDentist
DEN1000521DCMDDentist
019.026924ILMDDentist
60412KSMDDentist
21530MAMDDentist
2901011880MIMDDentist
03530NHMDDentist
DI02315900NJMDDentist
DS036752PAMDDentist
DEN02922RIMDDentist
016-0002216VTMDDentist
13642MDMDPharmacist
052549NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073543476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 WOODVIEW LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233573",
            "telephone_number": "248-626-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25882 ORCHARD LAKE RD",
            "address_2": "SUITE 105",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483369822",
            "telephone_number": "888-833-8441",
            "fax_number": "888-330-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLL",
        "first_name": "MARGO",
        "middle_name": "YELLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901011880",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052549",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS036752",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21530",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009567",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1000521",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN02922",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016-0002216",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02315900",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "03530",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "13642",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "60412",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3413200",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.