Active NPI
Angela N Cergnul, D.D.S.
- Dentist
- Warren, MI
National Provider Identifier
1326352345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901020279
- Practice address
- 6213 Chicago Rd
Ste 100
Warren, MI 48092-1697 - Phone
- (586) 264-5410
- Fax
- (586) 264-1119
- NPI assigned
- Aug 2, 2010
- Last updated
- Aug 2, 2010
- Sex
- Female
- 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 | 2901020279 | MI | Primary |
Addresses
Primary practice location
6213 Chicago Rd
Ste 100
Warren, MI 48092-1697
Mailing address
6213 Chicago Rd
Ste 100
Warren, MI 48092-1697
Phone (586) 264-5410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901020279 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benjamin J Underwood DDS LLC | Past | Accepting new patients | |
| Caredent PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Village Place Dental
- General Practice Dentistry
- Warren, MI
- NPI 1710449459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280707200000",
"number": "1326352345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6213 CHICAGO RD",
"address_2": "STE 100",
"city": "WARREN",
"state": "MI",
"postal_code": "480921697",
"telephone_number": "586-264-5410",
"fax_number": "586-264-1119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6213 CHICAGO RD",
"address_2": "STE 100",
"city": "WARREN",
"state": "MI",
"postal_code": "480921697",
"telephone_number": "586-264-5410",
"fax_number": "586-264-1119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERGNUL",
"first_name": "ANGELA",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-02",
"last_updated": "2010-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901020279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
- Center for Physical Medicine & Rehabilitation PC
- Center for Physical Medicine and Rehabilitation PC (Complete Orthotics)
- Center for Physical Medicine and Rehabilitiation (Complete Orthotics)
- Center for Weight Management
- Century Multipurpose Services,LLC (Warren Pharmacy)
- Mustafa Chahrour
- Chairat Chomchai M.D P.C
- Tweechard Chairatana, M.D.
- Chaldean Hearts Home Care
- Mahdi Chamas, DPM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.