Chad Mark Witkow, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901018384 Issued in MI

Practice address

4279 W Vienna Rd
Clio, MI 48420-9440

Phone

(810) 659-1721

Fax

(810) 659-1721

NPI assigned

Jan 18, 2007

Last updated

Sep 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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 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

Specialty

Oral Surgery

Education

University of Detroit Mercy School of Dentistry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Head and Neck Institute PCGroup PAC ID 0648344762, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Michigan Head & Neck Institute PC

  • Dentist
  • Warren, MI
  • NPI 1104871250
  Medicare reassignment Care Compare group NPD
• Michigan Dental Sleep Center Inc

  • General Practice Dentistry
  • Clio, MI
  • NPI 1376908392
  NPD Authorized official
• Michigan Dental Sleep Center Inc

  • Customized Equipment (DME)
  • Clio, MI
  • NPI 1679426134
  NPD Authorized official
• Clio Family Dentistry PLC

  • General Practice Dentistry
  • Clio, MI
  • NPI 1366050619
  Authorized official Same address or phone
• David a. Susko, DDS

  • Dental Clinic/Center
  • Roseville, MI
  • NPI 1497352363
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1316099179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4279 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484209440",
            "telephone_number": "810-659-1721",
            "fax_number": "810-659-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484209440",
            "telephone_number": "810-659-1721",
            "fax_number": "810-659-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITKOW",
        "first_name": "CHAD",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Warner, PA-C
• Anndrea Danae Weber
• Kelly Cay Welch
• Wildflower Therapy
• Mark J Williamson, D.D.S.
• David Lee Wood, RPH
• William Woods
• Andrea Lynn Worthing
• Worthwhile Wellness, PLLC
• Bailey Wright

• General Practice Dentistry in Clio, MI
• Providers in Clio, 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 Sep 14, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.