Individual provider Active NPI

Robert Jay Ault, DDS

  • Endodontics
  • Lansing, MI
National Provider Identifier
1194344580
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2901600453 Issued in MI
Practice address
6105 W St Joe Hwy Ste 203
Lansing, MI 48917-4850
Phone
(517) 351-0800
Fax
(517) 220-2172
NPI assigned
Apr 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 2901600453 MI Primary
General Practice Dentistry 1223G0001X 2901600453 MI
Prosthodontics 1223P0700X 2901600453 MI

Addresses

Primary practice location

6105 W St Joe Hwy Ste 203
Lansing, MI 48917-4850

Mailing address

6105 W St Joe Hwy Ste 203
Lansing, MI 48917-4850
Phone (517) 351-0800

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
2901600453MIMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Marzonie Gray & Associates PLLC CurrentSince Nov 22, 2020 Accepting new patients
Apnea Alternatives Single Specialty PastSince Nov 22, 2020 Accepting new patients

Locations

2900 Golfside Dr
Ste 6
Ann Arbor, MI 48108
Phone (734) 224-9121

2365 S Huron Pkwy
Ann Arbor, MI 48104
Phone (734) 677-1810

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1194344580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 W ST JOE HWY STE 203",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174850",
            "telephone_number": "517-351-0800",
            "fax_number": "517-220-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 W ST JOE HWY STE 203",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174850",
            "telephone_number": "517-351-0800",
            "fax_number": "517-220-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULT",
        "first_name": "ROBERT",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "2901600453",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600453",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "2901600453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.