Individual provider Active NPI

Christopher R Dyki, DDS

  • General Practice Dentistry
  • Eastpointe, MI
National Provider Identifier
1194826412
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018496 Issued in MI
Practice address
24840 Gratiot Ave
Eastpointe, MI 48021-3381
Phone
(586) 771-6340
Fax
(586) 771-6383
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901018496 MI Primary

Addresses

Primary practice location

24840 Gratiot Ave
Eastpointe, MI 48021-3381

Mailing address

24840 Gratiot Ave
Eastpointe, MI 48021-3381
Phone (586) 771-6340

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
I20160307000190 MI Order and Referring Only - DentistPractitioner - Dentist 4486950151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1194826412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24840 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213381",
            "telephone_number": "586-771-6340",
            "fax_number": "586-771-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24840 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213381",
            "telephone_number": "586-771-6340",
            "fax_number": "586-771-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKI",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

Verify at the official NPI Registry.