Regents of the University of Michigan School of Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

REGENTS OF THE UNIVERSITY OF MICHIGAN SCHOOL OF DENTISTRY

Practice address

1011 N University Ave
Ann Arbor, MI 48109-1078

Phone

(888) 707-2500

Fax

(734) 647-4024

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Romesh Nalliah, BDS

Title

Associate Dean for Patient Services

Phone

(888) 707-2500

Specialties & licenses 11

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

Regents of the University of Michigan School of Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Regents of the University of Michigan School of Dentistry

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1912152430
  NPD tax ID

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Renee E Duff, DDS

  • Dentist
  • Ann Arbor, MI
  • NPI 1467576686
  Medicare reassignment NPD
• Mark Fitzgerald, DDS

  • Dentist
  • Ann Arbor, MI
  • NPI 1710010962
  Medicare reassignment NPD
• Hom-Lay Wang, DDS

  • Dentist
  • Ann Arbor, MI
  • NPI 1316061757
  Medicare reassignment NPD
• David Jacobson, DDS

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1508984576

  Dentist

  NPD (past)
• Juan F Johnson, DDS

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1598887499

  Dentist

  NPD (past)
• Vernon E Rife, DDS

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1194858365

  Dentist

  NPD (past)
• Margarita Stanislavovna Katser, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Pittsburgh, PA
  • NPI 1235690405

  Dentist

  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1124143300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "888-707-2500",
            "fax_number": "734-647-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "888-707-2500",
            "fax_number": "734-647-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN SCHOOL OF DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "NALLIAH",
        "authorized_official_first_name": "ROMESH",
        "authorized_official_title_or_position": "ASSOCIATE DEAN FOR PATIENT SERVICES",
        "authorized_official_telephone_number": "888-707-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI MED SURGICAL",
            "identifier": "970H11102",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI MED SURGICAL",
            "identifier": "190H11093",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH",
            "identifier": "026194",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2667823",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4615102",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI DENTAL",
            "identifier": "D800336",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA HEALTHCARE OF MI",
            "identifier": "QMXPR0028409",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS OF MI",
            "identifier": "0985982",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP OF MI",
            "identifier": "43-29007",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4613082",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA OF MI GENL",
            "identifier": "88006",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "DD81017",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regents of the University of Michigan Dental Faculty Associates
• Regents of the University of Michigan Mworks
• Regents of the University of Michigan Oral Pathology
• Regents of the University of Michigan Oral Pathology
• Regents of the University of Michigan Pediatric Surgery Offsite
• Regents of the University of Michigan School of Dentistry
• Regents of the University of Michigan-Psychological Clinic
• Regents of the University of Michigan-Regional Alliance for Hea
• Regents of the University of Michigan-Uhs-University Health Ser
• Regents of the Universtiy of Michigan

• All providers in Ann Arbor, MI
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.