Individual provider Active NPI

Monica Vaisman, DDS

  • General Practice Dentistry
  • Dundee, MI
National Provider Identifier
1417094483
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18148 Issued in MI
Practice address
424 E Monroe St
Dundee, MI 48131-1380
Phone
(734) 529-3031
Fax
(734) 529-5827
NPI assigned
Jan 31, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 18148 MI Primary

Addresses

Primary practice location

424 E Monroe St
Dundee, MI 48131-1380

Mailing address

424 E Monroe St
Dundee, MI 48131-1380
Phone (734) 529-3031

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
I20160114000124 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0446552020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18148MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417094483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 E MONROE ST",
            "city": "DUNDEE",
            "state": "MI",
            "postal_code": "481311380",
            "telephone_number": "734-529-3031",
            "fax_number": "734-529-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 E MONROE ST",
            "city": "DUNDEE",
            "state": "MI",
            "postal_code": "481311380",
            "telephone_number": "734-529-3031",
            "fax_number": "734-529-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAISMAN",
        "first_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dundee, MI

Sources for this page

Verify at the official NPI Registry.