Individual provider Active NPI

John Krawitz, D.D.S.

  • General Practice Dentistry
  • West Bloomfield, MI
National Provider Identifier
1205972734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901013167 Issued in MI
Practice address
5813 W Maple Rd
Suite 145
West Bloomfield, MI 48322-4400
Phone
(248) 626-7100
Fax
(248) 626-6358
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

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 2901013167 MI Primary

Addresses

Primary practice location

5813 W Maple Rd
Suite 145
West Bloomfield, MI 48322-4400

Mailing address

5813 W Maple Rd
Suite 145
West Bloomfield, MI 48322-4400
Phone (248) 626-7100

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
I20160314000046 MI Order and Referring Only - DentistPractitioner - Dentist 1355647637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901013167MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205972734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5813 W MAPLE RD",
            "address_2": "SUITE 145",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224400",
            "telephone_number": "248-626-7100",
            "fax_number": "248-626-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5813 W MAPLE RD",
            "address_2": "SUITE 145",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224400",
            "telephone_number": "248-626-7100",
            "fax_number": "248-626-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAWITZ",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.