Individual provider Active NPI

Jonathan E Rago, DDS

  • Dentist
  • Clinton Township, MI
National Provider Identifier
1417843079
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901602553 Issued in MI
Practice address
35525 Garfield Rd
Clinton Township, MI 48035-5521
Phone
(586) 792-4550
NPI assigned
Jun 17, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901602553 MI Primary

Addresses

Primary practice location

35525 Garfield Rd
Clinton Township, MI 48035-5521

Mailing address

12193 Forest Glen LN
Shelby Township, MI 48315-1761

Other practice location 1

25865 W 12 Mile Rd Ste D-112
Southfield, MI 48034-1817
Phone (248) 353-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901602553MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gantz, D.D.S., P.L.L.C. Dentist Past Accepting new patients
Gantz DDS PLLC Dentist PastSince Apr 5, 2016 Accepting new patients

Organizations & group practices 2

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": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1417843079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12193 FOREST GLEN LN",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483151761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35525 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480355521",
            "telephone_number": "586-792-4550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25865 W 12 Mile Rd Ste D-112",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480341817",
            "country_code": "US",
            "telephone_number": "248-353-4010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAGO",
        "first_name": "JONATHAN",
        "middle_name": "E",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.