Active NPI
Bruce Edward Hulscher, DDS
- Dentist
- Walled Lake, MI
National Provider Identifier
1376606269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 014867
- Practice address
- 1881 N Pontiac Trail
Suite D
Walled Lake, MI 48390 - Phone
- (248) 960-4848
- Fax
- (248) 960-3022
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- 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 | 014867 | MI | Primary |
Addresses
Primary practice location
1881 N Pontiac Trail
Suite D
Walled Lake, MI 48390
Mailing address
1881 N Pontiac Trail
Suite D
Walled Lake, MI 48390
Phone (248) 960-4848
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 |
|---|---|---|---|
| 014867 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Institute of Advanced Dentistry P C | Current | Accepting new patients |
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.
-
- Dental Clinic/Center
- Walled Lake, MI
- NPI 1528548419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376606269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1881 N PONTIAC TRAIL",
"address_2": "SUITE D",
"city": "WALLED LAKE",
"state": "MI",
"postal_code": "48390",
"telephone_number": "248-960-4848",
"fax_number": "248-960-3022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1881 N PONTIAC TRAIL",
"address_2": "SUITE D",
"city": "WALLED LAKE",
"state": "MI",
"postal_code": "48390",
"telephone_number": "248-960-4848",
"fax_number": "248-960-3022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HULSCHER",
"first_name": "BRUCE",
"middle_name": "EDWARD",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "014867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walled Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.