Individual provider Active NPI

Tomaz Augusto Brito Pereira de Souza

  • Dentist
  • Ann Arbor, MI
National Provider Identifier
1386430247
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2952000871 Issued in MI
Practice address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone
(734) 647-4201
NPI assigned
Apr 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2952000871 MI Primary

Addresses

Primary practice location

1011 N University Ave
Ann Arbor, MI 48109-1078

Mailing address

2795 Windwood Dr Apt 166
Ann Arbor, MI 48105-3402
Phone (734) 596-4779

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
I20250505002080 MI Order and Referring Only - DentistPractitioner - Dentist 7416474325

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": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1386430247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 WINDWOOD DR APT 166",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481053402",
            "telephone_number": "734-596-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-647-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITO PEREIRA DE SOUZA",
        "first_name": "TOMAZ AUGUSTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2952000871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.