Individual provider Active NPI

Michael John Vilag, D.D.S.

  • Dentist
  • Grosse Ile, MI
National Provider Identifier
1174965339
Registry record updated Jan 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021030 Issued in MI
Practice address
24201 Meridian Rd
Grosse Ile, MI 48138-2134
Phone
(734) 692-0102
Fax
(734) 692-1541
NPI assigned
Jul 29, 2013
Last updated
Jan 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021030 MI Primary

Addresses

Primary practice location

24201 Meridian Rd
Grosse Ile, MI 48138-2134

Mailing address

24201 Meridian Rd
Grosse Ile, MI 48138-2134
Phone (734) 692-0102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901021030MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J Vilag DDS PC CurrentSince Jun 21, 2022 Accepting new patients
Beverly T Morris DDS PC PastSince Jan 19, 2020 Accepting new patients
Birchtree Dental Center Past Accepting new patients

Locations

24201 Meridian Rd
Grosse Ile, MI 48138
Phone (734) 301-3240

Organizations & group practices 3

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": "1375056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578700800000",
    "number": "1174965339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24201 MERIDIAN RD",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481382134",
            "telephone_number": "734-692-0102",
            "fax_number": "734-692-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24201 MERIDIAN RD",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481382134",
            "telephone_number": "734-692-0102",
            "fax_number": "734-692-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILAG",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-29",
        "last_updated": "2020-01-11",
        "certification_date": "2020-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Ile, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.