Individual provider Active NPI

Stephanie Busch-Abbate, DDS

  • General Practice Dentistry
  • Kalamazoo, MI
National Provider Identifier
1114156338
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19983 Issued in MI
Practice address
3048 W Main St
Kalamazoo, MI 49006-2956
Phone
(269) 381-3890
Fax
(269) 381-9743
NPI assigned
Jul 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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 19983 MI Primary

Addresses

Primary practice location

3048 W Main St
Kalamazoo, MI 49006-2956

Mailing address

3048 W Main St
Kalamazoo, MI 49006-2956
Phone (269) 381-3890

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
I20150625001378 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5496066813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19983MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stephanie M Busch-Abbate, DDS, PLC 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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1114156338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062956",
            "telephone_number": "269-381-3890",
            "fax_number": "269-381-9743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062956",
            "telephone_number": "269-381-3890",
            "fax_number": "269-381-9743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH-ABBATE",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "19983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.