Michael Peter Campeau, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901018633 Issued in MI

Practice address

661 E. Main St.
Fremont, MI 49412

Phone

(231) 924-2320

Fax

(231) 924-1518

NPI assigned

Oct 11, 2005

Last updated

Aug 9, 2010By 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

Other identifiers 13

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Michael P Campeau, DDS, PC

  • Dental Clinic/Center
  • Fremont, MI
  • NPI 1902285620
  NPD (past) Authorized official
• Great Lakes Bay Health Centers

  dba Great Lakes Bay Health Centers Integrated Care Midland

  • Federally Qualified Health Center (FQHC)
  • Midland, MI
  • NPI 1609609536
  NPD (past)
• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1871684761
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1336137645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 E. MAIN ST.",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "49412",
            "telephone_number": "231-924-2320",
            "fax_number": "231-924-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 E. MAIN ST.",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "49412",
            "telephone_number": "231-924-2320",
            "fax_number": "231-924-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPEAU",
        "first_name": "MICHAEL",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOLDEN DENTAL PLANS",
            "identifier": "381908328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GUARDIAN",
            "identifier": "381908328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCE",
            "identifier": "88171MI",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTER DRIVE",
            "identifier": "88170MI",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "O1493248",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL HEALTH ALLIANCE",
            "identifier": "381908328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METLIFE",
            "identifier": "381908328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BLUE",
            "identifier": "381908328020",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "D801095",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4527190",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WADSWORTH",
            "identifier": "88096MI",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTEMAX",
            "identifier": "381908328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BAYSIDE",
            "identifier": "88123MI",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tianna Lynn Burns, C.O.T.A
• Stacey Butch, PHARMD
• Koby J Buth, MD
• Jeffrey B Byland, O.D.
• C & C Optical Shop Inc.
• John William Carlson Jr., RPH
• Chad Carpenter
• Brooke Ashton Castillo, OD
• Randall J. Ceton, M.D.
• Alexa Chapman, M.A., CCC-SLP

• Dentist in Fremont, MI
• Providers in Fremont, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.