Individual provider Active NPI

Joseph D Ebeling, D.D.S.

  • General Practice Dentistry
  • Adrian, MI
National Provider Identifier
1316153802
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017376 Issued in MI
Practice address
3142 N Adrian Hwy
Adrian, MI 49221-1179
Phone
(517) 263-6100
Fax
(517) 263-6110
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901017376 MI Primary

Addresses

Primary practice location

3142 N Adrian Hwy
Adrian, MI 49221-1179

Mailing address

3142 N. Adrian Hwy
Adrian, MI 49221
Phone (517) 263-6100

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
I20170202000283 MI Order and Referring Only - DentistPractitioner - Dentist 9335422187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ebeling Family Dentistry, PLLC General Practice Current Accepting new patients

Locations

3142 N Adrian Hwy
Adrian, MI 49221
Phone (517) 263-6100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316153802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 N. ADRIAN HWY",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "49221",
            "telephone_number": "517-263-6100",
            "fax_number": "517-263-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 N ADRIAN HWY",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211179",
            "telephone_number": "517-263-6100",
            "fax_number": "517-263-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBELING",
        "first_name": "JOSEPH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.