Paul L. Michaelides, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

24486 Issued in CA

Practice address

2503 W. Shaw
Suite 105
Fresno, CA 93711-3309

Phone

(155) 922-9450

Fax

(155) 922-6128

NPI assigned

Oct 2, 2006

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306930748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 W. SHAW",
            "address_2": "SUITE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113309",
            "telephone_number": "155-922-9450",
            "fax_number": "155-922-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 W. SHAW",
            "address_2": "SUITE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113309",
            "telephone_number": "155-922-9450",
            "fax_number": "155-922-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELIDES",
        "first_name": "PAUL",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "24486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael M. Bohn, DDS, Inc.
• Michael Martines Physical Therapist,
• Michael R Oberto MD Inc
• Michael S. Stubblefield, MD. Inc.
• Iris Michael
• Onyedikachi Kenneth Michaels, M.D.
• Sofia Michailides
• Elizabeth Renee Michel, ATC
• Michele Greenhouse MD
• Jamie M Micheli

• Periodontics in Fresno, CA
• Providers in Fresno, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.