Individual provider Active NPI

Anna Marie Pogoncheff, DDS

  • Dentist
  • Lansing, MI
National Provider Identifier
1154768414
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020956 Issued in MI
Practice address
2628 Lake Lansing Rd
Suite 101
Lansing, MI 48912-3668
Phone
(517) 420-8893
Fax
(517) 482-5637
NPI assigned
May 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020956 MI Primary

Addresses

Primary practice location

2628 Lake Lansing Rd
Suite 101
Lansing, MI 48912-3668

Mailing address

2628 Lake Lansing Rd
Ste 101
Lansing, MI 48912-3668
Phone (517) 482-5636

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
I20160518000733 MI Order and Referring Only - DentistPractitioner - Dentist 6901195791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020956MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Metodi C Pogoncheff DDS PC 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": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1154768414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2628 LAKE LANSING RD",
            "address_2": "STE 101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123668",
            "telephone_number": "517-482-5636",
            "fax_number": "517-482-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 LAKE LANSING RD",
            "address_2": "SUITE 101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123668",
            "telephone_number": "517-420-8893",
            "fax_number": "517-482-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGONCHEFF",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.