Active NPI
James Emmanuel Tangalos, DMD
- Dentist
- Roseville, MI
National Provider Identifier
1174184055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901600535
- Practice address
- 21055 E 12 Mile Rd
Roseville, MI 48066-2205 - Phone
- (586) 789-9528
- NPI assigned
- Jun 22, 2019
- Last updated
- Jan 11, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901600535 | MI | Primary |
Addresses
Primary practice location
21055 E 12 Mile Rd
Roseville, MI 48066-2205
Mailing address
51540 Van Dyke Ave
Shelby TWP, MI 48316-4446
Phone (586) 265-2004
Other practice location 1
51540 Van Dyke Ave
Shelby Twp, MI 48316-4446
Phone (586) 265-2004
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190817000506 | MI | Order and Referring Only - Dentist | 4082942800 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901600535 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J2Dental, PLLC | Dentist | Current | Accepting new patients |
Locations
51540 Van Dyke Ave
Shelby Township, MI 48316
Phone (586) 265-2004
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768089600000",
"number": "1174184055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51540 VAN DYKE AVE",
"city": "SHELBY TWP",
"state": "MI",
"postal_code": "483164446",
"telephone_number": "586-265-2004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21055 E 12 MILE RD",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480662205",
"telephone_number": "586-789-9528"
}
],
"practiceLocations": [
{
"address_1": "51540 Van Dyke Ave",
"address_purpose": "LOCATION",
"city": "Shelby Twp",
"state": "MI",
"postal_code": "483164446",
"country_code": "US",
"telephone_number": "586-265-2004",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANGALOS",
"first_name": "JAMES",
"middle_name": "EMMANUEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-22",
"last_updated": "2026-01-11",
"certification_date": "2026-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901600535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.