Individual provider Active NPI

Michael George O'Callaghan, DDS

  • Dentist
  • Allegan, MI
National Provider Identifier
1386622017
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
013112 Issued in MI
Practice address
1630 Lincoln Rd
Allegan, MI 49010-9410
Phone
(269) 673-7274
NPI assigned
Jan 3, 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
Dentist 122300000X 013112 MI Primary

Addresses

Primary practice location

1630 Lincoln Rd
Allegan, MI 49010-9410

Mailing address

315 Old Pine Rd
Allegan, MI 49010-9159
Phone (269) 673-3152

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
I20160310000441 MI Order and Referring Only - DentistPractitioner - Dentist 2961708300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013112MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386622017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 OLD PINE RD",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109159",
            "telephone_number": "269-673-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 LINCOLN RD",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490109410",
            "telephone_number": "269-673-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CALLAGHAN",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "013112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allegan, MI

Sources for this page

Verify at the official NPI Registry.