Individual provider Active NPI

Michelle Claudine Dziurgot, DDS

  • General Practice Dentistry
  • Shelby TWP, MI
National Provider Identifier
1407812571
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017102 Issued in MI
Practice address
50202 Schoenherr
Shelby TWP, MI 48315
Phone
(586) 247-8000
Fax
(586) 247-8007
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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 2901017102 MI Primary

Addresses

Primary practice location

50202 Schoenherr
Shelby TWP, MI 48315

Mailing address

50202 Schoenherr
Shelby TWP, MI 48315
Phone (586) 247-8000

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
I20150610001379 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9032430475

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1407812571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50202 SCHOENHERR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "48315",
            "telephone_number": "586-247-8000",
            "fax_number": "586-247-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50202 SCHOENHERR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "48315",
            "telephone_number": "586-247-8000",
            "fax_number": "586-247-8007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIURGOT",
        "first_name": "MICHELLE",
        "middle_name": "CLAUDINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

Verify at the official NPI Registry.