Individual provider Active NPI

Michael Linebaugh, DDS

  • Prosthodontics
  • Grosse Pointe Woods, MI
National Provider Identifier
1376653949
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
9850 Issued in MI
Practice address
696 Lochmoor Blvd
Grosse Pointe Woods, MI 48236-1752
Phone
(313) 881-3979
NPI assigned
Aug 30, 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 9850 MI Primary

Addresses

Primary practice location

696 Lochmoor Blvd
Grosse Pointe Woods, MI 48236-1752

Mailing address

696 Lochmoor Blvd
Grosse Pointe Woods, MI 48236-1752
Phone (313) 881-3979

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
I20130405000051 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7618112012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9850MIMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376653949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 LOCHMOOR BLVD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361752",
            "telephone_number": "313-881-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 LOCHMOOR BLVD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361752",
            "telephone_number": "313-881-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINEBAUGH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "9850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.