David Richard Backus, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901012277 Issued in MI

Practice address

4633 Dow Ridge Rd
Orchard Lake, MI 48324-2326

Phone

(248) 310-9233

NPI assigned

Aug 12, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• David R Backus DDS

  • Dentist
  • Orchard Lake, MI
  • NPI 1194127258

  Single Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1295346351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4633 DOW RIDGE RD",
            "city": "ORCHARD LAKE",
            "state": "MI",
            "postal_code": "483242326",
            "telephone_number": "248-310-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4633 DOW RIDGE RD",
            "city": "ORCHARD LAKE",
            "state": "MI",
            "postal_code": "483242326",
            "telephone_number": "248-310-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKUS",
        "first_name": "DAVID",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901012277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Orchard Lake, MI
• Providers in Orchard Lake, 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 Aug 12, 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.