Individual provider Active NPI

Jeffrey L. Golombisky, D.D.S.

  • General Practice Dentistry
  • Owosso, MI
National Provider Identifier
1376665281
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901013149 Issued in MI
Practice address
1336 E M 21
Owosso, MI 48867-9039
Phone
(989) 723-8135
Fax
(989) 723-8649
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 2901013149 MI Primary

Addresses

Primary practice location

1336 E M 21
Owosso, MI 48867-9039

Mailing address

1336 E M 21
Owosso, MI 48867-9039
Phone (989) 723-8135

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
2901013149MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey L. Golombisky PastSince Apr 28, 2024 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.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1376665281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 E M 21",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679039",
            "telephone_number": "989-723-8135",
            "fax_number": "989-723-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 E M 21",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679039",
            "telephone_number": "989-723-8135",
            "fax_number": "989-723-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOMBISKY",
        "first_name": "JEFFREY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.