Individual provider Active NPI

Janelle McQueen, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Southfield, MI
National Provider Identifier
1295335891
Registry record updated Nov 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2901022805 Issued in MI
Practice address
29702 Southfield Rd Ste H
Southfield, MI 48076-2096
Phone
(248) 559-4800
NPI assigned
Nov 1, 2020
Last updated
Nov 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2901022805 MI Primary

Addresses

Primary practice location

29702 Southfield Rd Ste H
Southfield, MI 48076-2096

Mailing address

3574 Wabeek Lake Dr W
Bloomfield Hills, MI 48302-1271

Other practice location 1

24405 Michigan Ave
Dearborn, MI 48124-1827
Phone (313) 730-1213

Other practice location 2

33880 S Gratiot Ave
Clinton Township, MI 48035-6117
Phone (486) 790-7970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901022805MIMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jana Tumpkin McQueen D.D.S PC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

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, 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": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604188800000",
    "number": "1295335891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3574 WABEEK LAKE DR W",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29702 SOUTHFIELD RD STE H",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762096",
            "telephone_number": "248-559-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24405 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481241827",
            "country_code": "US",
            "telephone_number": "313-730-1213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33880 S Gratiot Ave",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480356117",
            "country_code": "US",
            "telephone_number": "486-790-7970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCQUEEN",
        "first_name": "JANELLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-01",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901022805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.