Robert Ogden Reisig Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12230 Issued in MI

Practice address

1820 Sinclair St
Suite B
St Clair, MI 48079

Phone

(810) 329-3111

Fax

(810) 329-3188

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Robert Reisig DDS PC

  • Dentist
  • St Clair, MI
  • NPI 1568423689
  NPD (past) Authorized official

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407921893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 SINCLAIR ST",
            "address_2": "SUITE B",
            "city": "ST CLAIR",
            "state": "MI",
            "postal_code": "48079",
            "telephone_number": "810-329-3111",
            "fax_number": "810-329-3188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 SINCLAIR ST",
            "address_2": "SUITE B",
            "city": "ST CLAIR",
            "state": "MI",
            "postal_code": "48079",
            "telephone_number": "810-329-3111",
            "fax_number": "810-329-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISIG",
        "first_name": "ROBERT",
        "middle_name": "OGDEN",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "12230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Pietrangelo, MD
• Ashley Piper
• Shannon Leigh Porter
• Alexi Abigail Rankin
• Andrew James Reid, BT
• Rewire Your Mind Behavioral Health Counseling Services, LLC
• Robert Reisig DDS PC
• Kathryn Jeanne Robinson, OCCUPATIONAL THERAPY
• Sherry A Russell, MSN APRN BC
• RX Family Home Care Services, LLC

• Dentist in St Clair, MI
• Providers in St Clair, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.