Individual provider Active NPI

Brian Yetter, DDS

  • Dentist
  • Ann Arbor, MI
National Provider Identifier
1073927034
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021237 Issued in MI
Practice address
2215 Fuller Rd
Ann Arbor, MI 48105-2303
Phone
(734) 769-7100
NPI assigned
Jun 18, 2014
Last updated
Feb 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021237 MI Primary

Addresses

Primary practice location

2215 Fuller Rd
Ann Arbor, MI 48105-2303

Mailing address

1200 S Detroit Ave
Dental Service
Toledo, OH 43614
Phone (419) 213-7515

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
I20160108000407 MI Order and Referring Only - DentistPractitioner - Dentist 0547562571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021237MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1073927034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S DETROIT AVE",
            "address_2": "DENTAL SERVICE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43614",
            "telephone_number": "419-213-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 FULLER RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052303",
            "telephone_number": "734-769-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YETTER",
        "first_name": "BRIAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.