Individual provider Active NPI

Annette Mary Skowronski-Langworthy

  • General Practice Dentistry
  • Shelby Township, MI
National Provider Identifier
1407806227
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D14465 Issued in MI
Practice address
46671 Hayes Rd
Shelby Township, MI 48315-5506
Phone
(586) 566-3880
Fax
(586) 566-3982
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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 D14465 MI Primary

Addresses

Primary practice location

46671 Hayes Rd
Shelby Township, MI 48315-5506

Mailing address

46671 Hayes Rd
Shelby Township, MI 48315-5506
Phone (586) 566-3880

Other names 1

  • Dr. Annette Mary Skowronski Professional name

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
I20170112001620 MI Order and Referring Only - DentistPractitioner - Dentist 6709934896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14465MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1407806227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46671 HAYES RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155506",
            "telephone_number": "586-566-3880",
            "fax_number": "586-566-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46671 HAYES RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155506",
            "telephone_number": "586-566-3880",
            "fax_number": "586-566-3982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOWRONSKI-LANGWORTHY",
        "first_name": "ANNETTE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D14465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "SKOWRONSKI",
            "middle_name": "MARY",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.