Individual provider Active NPI

Michael J Guest Jr., D.D.S.

  • General Practice Dentistry
  • Grosse Pointe Woods, MI
National Provider Identifier
1356442958
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901015083 Issued in MI
Practice address
19557 Mack Ave
Grosse Pointe Woods, MI 48236-2859
Phone
(313) 885-7776
Fax
(313) 885-0032
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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 2901015083 MI Primary

Addresses

Primary practice location

19557 Mack Ave
Grosse Pointe Woods, MI 48236-2859

Mailing address

19557 Mack Ave
Grosse Pointe Woods, MI 48236-2859
Phone (313) 885-7776

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

LicenseStateTypeSpecialty
2901015083MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J. Guest, Jr., D.D.S., P.C. CurrentSince Aug 7, 2022 Accepting new patients

Locations

19557 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (313) 882-4530

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1356442958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19557 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362859",
            "telephone_number": "313-885-7776",
            "fax_number": "313-885-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19557 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362859",
            "telephone_number": "313-885-7776",
            "fax_number": "313-885-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEST",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.