Individual provider Active NPI

William Michael Berkowski, D.D.S

  • General Practice Dentistry
  • Dearborn, MI
National Provider Identifier
1164443636
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901011887 Issued in MI
Practice address
15020 Michigan Ave
Dearborn, MI 48126-2914
Phone
(313) 582-3900
Fax
(313) 582-3843
NPI assigned
Jul 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 2901011887 MI Primary

Addresses

Primary practice location

15020 Michigan Ave
Dearborn, MI 48126-2914

Mailing address

15020 Michigan Ave
Dearborn, MI 48126-2914
Phone (313) 582-3900

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
I20160215001829 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3577867316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901011887MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164443636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15020 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262914",
            "telephone_number": "313-582-3900",
            "fax_number": "313-582-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15020 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262914",
            "telephone_number": "313-582-3900",
            "fax_number": "313-582-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKOWSKI",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901011887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.