Individual provider Active NPI

Theodora E Danciu, DMD, DMSC

  • Oral and Maxillofacial Pathology Dentistry
  • Ann Arbor, MI
National Provider Identifier
1184861080
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
2901019744 Issued in MI
Practice address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone
(734) 763-6933
Fax
(734) 764-2469
NPI assigned
Jan 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019744 MI
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X PATHOLOGY2 MI
Oral and Maxillofacial Pathology Dentistry 1223P0106X 2901019744 MI Primary

Addresses

Primary practice location

1011 N University Ave
Ann Arbor, MI 48109-1078

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090311000169 MI Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 8628134939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Harvard Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of Michigan Oral PathologyGroup PAC ID 2466414685, 4 clinicians

Practice addresses (Care Compare)

1011 N University Ave
Regents of Univ Mi Dentl Associates
Ann Arbor, MI 48109-1078
Phone (734) 764-3155

1011 N University RM
G018
Ann Arbor, MI 48109-1078
Phone (734) 764-1543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901019744MIMDOral and Maxillofacial Pathology Dentist
PATHOLOGY2MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Oral Pathology Oral and Maxillofacial Pathology Current Accepting new patients
Regents of the University of Michigan Oral Pathology Dentist CurrentSince Oct 28, 2008 Accepting new patients
Regents of the University of Michigan Dental Faculty Associates Dentist CurrentSince Aug 1, 2018 Accepting new patients

Locations

1011 N University Ave
Ann Arbor, MI 48109
Phone (734) 763-6933

1011 N University Ave
Rm G18
Ann Arbor, MI 48109
Phone (734) 764-1543

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": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1184861080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-763-6933",
            "fax_number": "734-764-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCIU",
        "first_name": "THEODORA",
        "middle_name": "E",
        "credential": "DMD, DMSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019744",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "PATHOLOGY2",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MI",
            "license": "2901019744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.