Theodore Mark Healy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9353 Issued in MI

Practice address

1359 Champaign
Lincoln Park, MI 48146-3303

Phone

(313) 386-9660

Fax

(313) 386-5515

NPI assigned

Sep 14, 2006

Sex

Male

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

State licenses

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.

• Galayda & Shackleford DDS PC

  • General Practice Dentistry
  • Lincoln Park, MI
  • NPI 1265975551
  NPD (past)
• The Dental Clinic PC

  • General Practice Dentistry
  • Lincoln Park, MI
  • NPI 1003929662
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114022795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37956 RHONSWOOD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481679752",
            "telephone_number": "248-474-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 CHAMPAIGN",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463303",
            "telephone_number": "313-386-9660",
            "fax_number": "313-386-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEALY",
        "first_name": "THEODORE",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "9353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Harrison
• Barbara Ann Haslip, LMSW
• Cytisaney Hatch
• Hiyam Ali Hazime
• Health One Medical Center
• Kaila Wellsley Hemphill
• April Thomas Henley, LMSW
• HH Investment Holdings LLC
• Aida Hijazi
• Hiwassee Pharmacy

• General Practice Dentistry in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.