Individual provider Active NPI

Daniel Alejandro Cabrera, D.D.S.

  • Dentist
  • Wyoming, MI
National Provider Identifier
1255789590
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021900 Issued in MI
Practice address
2929 Burlingame Ave SW
Wyoming, MI 49509-2600
Phone
(616) 965-8333
NPI assigned
May 26, 2016
Last updated
Mar 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021900 MI Primary

Addresses

Primary practice location

2929 Burlingame Ave SW
Wyoming, MI 49509-2600

Mailing address

2929 Burlingame Ave SW
Wyoming, MI 49509-2600
Phone (616) 965-8333

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
I20160824000161 MI Order and Referring Only - DentistPractitioner - Dentist 1254626690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry Street Services Inc Dentist Past Accepting new patients
Cherry Street Services, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1255789590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 BURLINGAME AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495092600",
            "telephone_number": "616-965-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 BURLINGAME AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495092600",
            "telephone_number": "616-965-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "DANIEL",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.