Individual provider Active NPI

Susan Joy-Schlater Malone, D.D.S., P.C.

  • General Practice Dentistry
  • Petoskey, MI
National Provider Identifier
1407932593
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13952 Issued in MI
Practice address
231 State St
Petoskey, MI 49770-2785
Phone
(231) 347-6932
Fax
(231) 347-0292
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 13952 MI Primary

Addresses

Primary practice location

231 State St
Petoskey, MI 49770-2785

Mailing address

231 State St
Petoskey, MI 49770-2785
Phone (231) 347-6932

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
I20151202000140 MI Order and Referring Only - DentistPractitioner - Dentist 2668772310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13952MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Susan JS Malone, DDS, PC General Practice Current Accepting new patients

Locations

231 State St
Petoskey, MI 49770
Phone (231) 347-6151

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407932593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 STATE ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702785",
            "telephone_number": "231-347-6932",
            "fax_number": "231-347-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 STATE ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702785",
            "telephone_number": "231-347-6932",
            "fax_number": "231-347-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "SUSAN",
        "middle_name": "JOY-SCHLATER",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.