Individual provider Active NPI

David Anthony Susko, D.D.S.

  • General Practice Dentistry
  • Roseville, MI
National Provider Identifier
1275685018
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901015074 Issued in MI
Practice address
20737 E 13 Mile Rd
Roseville, MI 48066-4503
Phone
(586) 294-7810
NPI assigned
Jan 18, 2007
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 2901015074 MI Primary

Addresses

Primary practice location

20737 E 13 Mile Rd
Roseville, MI 48066-4503

Mailing address

20737 E 13 Mile Rd
Roseville, MI 48066-4503
Phone (586) 294-7810

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160428002196 MI Order and Referring Only - General PracticePractitioner - General Practice 5799084588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
David a. Susko, DDS CurrentSince Oct 11, 2020 Accepting new patients

Locations

20737 E 13 Mile Rd
Roseville, MI 48066
Phone (586) 294-7810

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275685018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20737 E 13 MILE RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664503",
            "telephone_number": "586-294-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20737 E 13 MILE RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664503",
            "telephone_number": "586-294-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSKO",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

Verify at the official NPI Registry.