Julie Ann Dugan, DDS
Individual provider
Active NPI
Dentist · Charlevoix, MI
NPI 1386798015 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1386798015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2901017569 (MI)
- Practice address
- 220 W Garfield Ave
Charlevoix, MI 49720-1631
- Phone
- (231) 547-6523
- Fax
- (231) 547-6238
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
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.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20190923003453 |
MI |
Order and Referring Only - Dentist
Practitioner - Dentist |
9133429970 |
|
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|
| 2901017569 | MI | MD | Dentist |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Dentist |
122300000X |
2901017569 |
MI |
Yes |
Addresses
Primary practice location
220 W Garfield Ave
Charlevoix, MI 49720-1631
Mailing address
7170 Applewood Dr
Charlevoix, MI 49720-2602
Phone (231) 881-0596
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 4870562 | Medicaid | MI | |
| 4616450 | Medicaid | MI | |