Susanna Fisenkova, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2951000869 Issued in MI

Practice address

2685 Tittabawassee Rd
Saginaw, MI 48604-8217

Phone

(989) 755-6600

NPI assigned

May 24, 2021

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Plev Sag, PLC

  • Dentist
  • Saginaw, MI
  • NPI 1891103040
  NPD (past)

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1093380883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30430 FOX CLUB CT",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483311943",
            "telephone_number": "248-773-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 TITTABAWASSEE RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486048217",
            "telephone_number": "989-755-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISENKOVA",
        "first_name": "SUSANNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2951000869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First State Hospice Care Inc
• First State Private Duty Inc
• Benjamin Fischer
• Jenny Fischer
• Matthew Fischer
• Brianna Fish
• Alaina Grace Fisher, M.A., CCC-SLP
• Kelly Ann Fisher
• Alicia Fiske, LLMSW
• Destiny Fitzpatrick

• All providers in Saginaw, MI
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.