Individual provider Active NPI

Thomas Norman McLean, D.D.S., M.S.

  • Periodontics
  • Farmington Hills, MI
National Provider Identifier
1174725063
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2901013177 Issued in MI
Practice address
32905 W 12 Mile Rd
Suite #300
Farmington Hills, MI 48334-3342
Phone
(248) 553-3050
NPI assigned
Jun 3, 2007
Sex
Male
Sole proprietor
No

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
Periodontics 1223P0300X 2901013177 MI Primary

Addresses

Primary practice location

32905 W 12 Mile Rd
Suite #300
Farmington Hills, MI 48334-3342

Mailing address

32905 W 12 Mile Rd
Suite #300
Farmington Hills, MI 48334-3342
Phone (248) 553-3050

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
I20150610001365 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042531485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2901013177MIMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174725063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32905 W 12 MILE RD",
            "address_2": "SUITE #300",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343342",
            "telephone_number": "248-553-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32905 W 12 MILE RD",
            "address_2": "SUITE #300",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343342",
            "telephone_number": "248-553-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "THOMAS",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901013177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.