Individual provider Active NPI

Robert Elmer Siegert, DDS

  • General Practice Dentistry
  • Livonia, MI
National Provider Identifier
1114024205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9016 Issued in MI
Practice address
15875 Middlebelt Rd
Suite 100
Livonia, MI 48154-3884
Phone
(734) 427-7337
Fax
(734) 427-9874
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9016 MI Primary

Addresses

Primary practice location

15875 Middlebelt Rd
Suite 100
Livonia, MI 48154-3884

Mailing address

15875 Middlebelt Rd
Suite 100
Livonia, MI 48154-3884
Phone (734) 427-7337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9016MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
James E Mikula DDS PC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114024205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15875 MIDDLEBELT RD",
            "address_2": "SUITE 100",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543884",
            "telephone_number": "734-427-7337",
            "fax_number": "734-427-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15875 MIDDLEBELT RD",
            "address_2": "SUITE 100",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543884",
            "telephone_number": "734-427-7337",
            "fax_number": "734-427-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGERT",
        "first_name": "ROBERT",
        "middle_name": "ELMER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "9016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.