Organization Active NPI

Jay a Werschky DDS PC

  • Dentist
  • Grand Blanc, MI
National Provider Identifier
1073831467
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11364 Issued in MI
Legal business name
JAY A WERSCHKY DDS PC
Practice address
5225 E Cook Rd
Grand Blanc, MI 48439-8388
Phone
(810) 695-7120
Fax
(810) 584-7467
NPI assigned
May 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Authorized official

Name
Dr. Jay A Werschky, DDSNPI 1013996693
Title
President/Owner
Phone
(810) 695-7120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 11364 MI Primary

Addresses

Primary practice location

5225 E Cook Rd
Grand Blanc, MI 48439-8388

Mailing address

5225 E Cook Rd
Grand Blanc, MI 48439-8388
Phone (810) 695-7120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161012002143 MI Part B Supplier - Clinic/Group Practice 0840588596 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Blanc, MI

National Provider Directory

National Provider Directory

Locations

5225 E Cook Rd
Ste N
Grand Blanc, MI 48439
Phone (810) 695-7120

5225 E Cook Rd
Grand Blanc, MI 48439
Phone (810) 694-8090

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1073831467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 E COOK RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398388",
            "telephone_number": "810-695-7120",
            "fax_number": "810-584-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 E COOK RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398388",
            "telephone_number": "810-695-7120",
            "fax_number": "810-584-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY A WERSCHKY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-10",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "WERSCHKY",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "810-695-7120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "11364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.