Individual provider Active NPI

Dominic Sutermeister, DDS

  • General Practice Dentistry
  • Saginaw, MI
National Provider Identifier
1396627113
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901602784 Issued in MI
Practice address
321 N Warren Ave
Saginaw, MI 48607-1500
Phone
(989) 754-7771
Fax
(833) 448-3258
NPI assigned
Jul 23, 2025
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 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 2901602784 MI Primary

Addresses

Primary practice location

321 N Warren Ave
Saginaw, MI 48607-1500

Mailing address

501 Lapeer Ave
Saginaw, MI 48607-1203
Phone (989) 759-6464

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
I20250731003706 MI Practitioner - Dentist 1850809989 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Bay Health Centers CurrentSince Aug 4, 2025 Accepting new patients
Great Lakes Bay Health Centers CurrentSince Aug 4, 2025 Accepting new patients

Locations

321 N Warren Ave
Saginaw, MI 48607
Phone (989) 754-7771

501 Lapeer Ave
Saginaw, MI 48607
Phone (989) 753-6000

501 Lapeer Ave
#R
Saginaw, MI 48607
Phone (989) 753-6000

Interoperability endpoints

  • Direct secure messaging: dominic.sutermeister.1@27771.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1396627113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071203",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N WARREN AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071500",
            "telephone_number": "989-754-7771",
            "fax_number": "833-448-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTERMEISTER",
        "first_name": "DOMINIC",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.