Individual provider Active NPI

Wayne Bruce Pursell, D.D.S.

  • Periodontics
  • Huntington Woods, MI
National Provider Identifier
1295715233
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2901017162 Issued in MI
Practice address
26789 Woodward Ave
Suite 202
Huntington Woods, MI 48070-1335
Phone
(248) 546-0022
Fax
(248) 546-6811
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2901017162 MI Primary

Addresses

Primary practice location

26789 Woodward Ave
Suite 202
Huntington Woods, MI 48070-1335

Mailing address

26789 Woodward Ave
Suite 202
Huntington Woods, MI 48070-1335
Phone (248) 546-0022

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
I20160122002041 MI Order and Referring Only - DentistPractitioner - Dentist 3577866656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295715233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26789 WOODWARD AVE",
            "address_2": "SUITE 202",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701335",
            "telephone_number": "248-546-0022",
            "fax_number": "248-546-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26789 WOODWARD AVE",
            "address_2": "SUITE 202",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701335",
            "telephone_number": "248-546-0022",
            "fax_number": "248-546-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURSELL",
        "first_name": "WAYNE",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901017162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Woods, MI

Sources for this page

Verify at the official NPI Registry.