Active NPI
Michael Frank Jermov, DDS
- Dentist
- Inkster, MI
National Provider Identifier
1326074717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901013472
- Practice address
- 1444 Inkster Rd
Inkster, MI 48141-1829 - Phone
- (313) 565-5980
- Fax
- (313) 565-5097
- NPI assigned
- Jun 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901013472 | MI | Primary |
Addresses
Primary practice location
1444 Inkster Rd
Inkster, MI 48141-1829
Mailing address
13756 Merrie Meadow LN
South Lyon, MI 48178
Phone (248) 486-2656
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160323002245 | MI | Order and Referring Only - Oral Surgery | 5890704340 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901013472 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326074717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13756 MERRIE MEADOW LN",
"city": "SOUTH LYON",
"state": "MI",
"postal_code": "48178",
"telephone_number": "248-486-2656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1444 INKSTER RD",
"city": "INKSTER",
"state": "MI",
"postal_code": "481411829",
"telephone_number": "313-565-5980",
"fax_number": "313-565-5097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JERMOV",
"first_name": "MICHAEL",
"middle_name": "FRANK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901013472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Inkster, MI
Sources for this page
- 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.