Robert M Dery, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14396 Issued in MI

Practice address

24255 W 13 Mile Rd
Suite 170
Bingham Farms, MI 48025-4320

Phone

(248) 646-4068

Fax

(248) 646-4839

NPI assigned

Mar 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225158959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24255 W 13 MILE RD",
            "address_2": "SUITE 170",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254320",
            "telephone_number": "248-646-4068",
            "fax_number": "248-646-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24255 W 13 MILE RD",
            "address_2": "SUITE 170",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254320",
            "telephone_number": "248-646-4068",
            "fax_number": "248-646-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERY",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D14396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek R. Nykiel DDS PC
• Mona Derentz, DDS
• Allyssa Taylor Derks
• David James Derouselle II
• Matthew Robert Dery, DDS
• Jacob Deskovitz
• Detroit Medical Devices, LLC
• Kara Anne Devito
• Kiersten Taylor Devolder
• Catherine I Devor, CRNA

• General Practice Dentistry in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.