Individual provider Active NPI

David J Bartolovic, DDS

  • Prosthodontics
  • Warren, MI
National Provider Identifier
1366534117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
2901018768 Issued in MI
Practice address
13403 13 Mile Rd
Warren, MI 48088
Phone
(586) 979-2800
Fax
(586) 979-2720
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 2901018768 MI Primary

Addresses

Primary practice location

13403 13 Mile Rd
Warren, MI 48088

Mailing address

13403 13 Mile Rd
Warren, MI 48088
Phone (586) 979-2800

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731015193 MI Order and Referring Only - DentistPractitioner - Dentist 1254645419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366534117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13403 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48088",
            "telephone_number": "586-979-2800",
            "fax_number": "586-979-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13403 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48088",
            "telephone_number": "586-979-2800",
            "fax_number": "586-979-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOLOVIC",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "2901018768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.