Individual provider Active NPI

Dennis George Charnesky, DDS

  • General Practice Dentistry
  • Troy, MI
National Provider Identifier
1073634937
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901010784 Issued in MI
Practice address
4101 John R Rd Ste 100
Suite 100
Troy, MI 48085-3647
Phone
(248) 680-0775
Fax
(248) 680-1108
NPI assigned
Apr 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901010784 MI Primary

Addresses

Primary practice location

4101 John R Rd Ste 100
Suite 100
Troy, MI 48085-3647

Mailing address

4101 John R Road Suite 100
Suite 100
Troy, MI 48085
Phone (248) 680-0775

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
I20150605001101 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042531782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fadi Assaf DDS VI PLLC PastSince Feb 12, 2023 Accepting new patients
Troy John R Dental Practice Entity PC General Practice PastSince Jan 19, 2025 Accepting new patients

Organizations & group practices 2

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073634937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 JOHN R ROAD SUITE 100",
            "address_2": "SUITE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48085",
            "telephone_number": "248-680-0775",
            "fax_number": "248-680-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 JOHN R RD STE 100",
            "address_2": "SUITE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853647",
            "telephone_number": "248-680-0775",
            "fax_number": "248-680-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNESKY",
        "first_name": "DENNIS",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901010784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.