Carolyn Suzanne John, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901018814 Issued in MI

Practice address

3226 Hidden Timber Dr Ste B
Lake Orion, MI 48359-1598

Phone

(248) 393-1888

Fax

(248) 393-1890

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Oral Surgery

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seven Oaks Professional, PLLCGroup PAC ID 8729141049, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Seven Oaks Professional, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Orion, MI
  • NPI 1558510537
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1083782254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 HIDDEN TIMBER DR STE B",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483591598",
            "telephone_number": "248-393-1888",
            "fax_number": "248-393-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 HIDDEN TIMBER DR STE B",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483591598",
            "telephone_number": "248-393-1888",
            "fax_number": "248-393-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "CAROLYN",
        "middle_name": "SUZANNE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901018814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry a Dancik (Renal Redux)
• Jacob M Joa, RDN
• John D Arsen DPM Inc
• John Kitzmiller M.D. PC (Bald Mountain Behavioral Medicine)
• John P. Blake DDS PC
• Douglas Jones
• Journey Well Counseling, LLC
• Aisha Marie Judd
• Brook Kanneth
• Amita Kanyal

• Oral and Maxillofacial Surgery (Dentist) in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.