Individual provider Active NPI

Sandra Embree, DDS

  • General Practice Dentistry
  • Ann Arbor, MI
National Provider Identifier
1417095753
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15028 Issued in MI
Practice address
2340 E Stadium Blvd
Ste #7
Ann Arbor, MI 48104
Phone
(734) 973-0000
Fax
(734) 973-9650
NPI assigned
Feb 1, 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 15028 MI Primary

Addresses

Primary practice location

2340 E Stadium Blvd
Ste #7
Ann Arbor, MI 48104

Mailing address

2340 E Stadium Blvd
Ste #7
Ann Arbor, MI 48104
Phone (734) 973-0000

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
I20161228000722 MI Order and Referring Only - DentistPractitioner - Dentist 0941581227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15028MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Embree Dentistry General Practice Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417095753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 E STADIUM BLVD",
            "address_2": "STE #7",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-973-0000",
            "fax_number": "734-973-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 E STADIUM BLVD",
            "address_2": "STE #7",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-973-0000",
            "fax_number": "734-973-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMBREE",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "15028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.