Individual provider Active NPI

Michael Golden Long, D.D.S.

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1205858578
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29079 Issued in CA
Practice address
7730 N Fresno St
Ste. 102
Fresno, CA 93720-2408
Phone
(559) 432-4850
Fax
(559) 432-4718
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 29079 CA Primary

Addresses

Primary practice location

7730 N Fresno St
Ste. 102
Fresno, CA 93720-2408

Mailing address

7730 N Fresno St
Ste. 102
Fresno, CA 93720-2408
Phone (559) 432-4850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29079CAMDCritical Care Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael M. Bohn, DDS, Inc. PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205858578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 N FRESNO ST",
            "address_2": "STE. 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202408",
            "telephone_number": "559-432-4850",
            "fax_number": "559-432-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 N FRESNO ST",
            "address_2": "STE. 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202408",
            "telephone_number": "559-432-4850",
            "fax_number": "559-432-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MICHAEL",
        "middle_name": "GOLDEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.