Michael John Mauren, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901015857 Issued in MI

Practice address

9751 E Grand River Ave
Portland, MI 48875-9774

Phone

(517) 647-0081

Fax

(517) 647-0083

NPI assigned

Jun 5, 2007

Last updated

Mar 4, 2021By 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

Practice roles

Locations

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

• Michael J Mauren, DDS, PLLC

  • General Practice Dentistry
  • Portland, MI
  • NPI 1114655925
  NPD Authorized official
• Michigan Sleep Solutions LLC

  • Customized Equipment (DME)
  • Portland, MI
  • NPI 1255975561
  NPD Authorized official

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1245432780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8037 ABBEY RD",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "488759364",
            "telephone_number": "517-647-0081",
            "fax_number": "517-647-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9751 E GRAND RIVER AVE",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "488759774",
            "telephone_number": "517-647-0081",
            "fax_number": "517-647-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUREN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nancyann Pierce Lufkin, MSW
• Suzanne R Maystead, OD
• Nicole Ann McCrumb, PHARMD
• Dylan McKay, DO
• McLaren Central Michigan
• Monica Mead, PHARM. D

• General Practice Dentistry in Portland, MI
• Providers in Portland, 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 Mar 4, 2021; 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.