Michael Thomas Pink, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019026465 Issued in IL

Practice address

1303 Macom Dr
Naperville, IL 60564-3202

Phone

(630) 851-9100

Fax

(630) 851-6983

NPI assigned

May 1, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 20, 2017 through Apr 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Don C. Kalant Sr., D.D.S. and Assoc

  • Oral and Maxillofacial Surgery (Dentist)
  • Naperville, IL
  • NPI 1801035092
  NPD (past)

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

{
    "created_epoch": "1272672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1356668248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MACOM DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605643202",
            "telephone_number": "630-851-9100",
            "fax_number": "630-851-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MACOM DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605643202",
            "telephone_number": "630-851-9100",
            "fax_number": "630-851-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINK",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-01",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS037820",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019026465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Pietrzyk, D.C.
• Edith Pignotti, RN, CDE
• Gokila Pillai, M.D.
• Danielle Pincente, LCPC
• Ashley Katherine Pinckney
• Pinky Promise Pediatric Dentistry
• Pins Family Chiropractic
• Bradley William Pins, D.C.
• Lisa A Pinto, PSYD
• Pioneer Diagnostics and Research Corp

• Oral and Maxillofacial Surgery (Dentist) in Naperville, IL
• Providers in Naperville, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.