Theodore L. Degenhardt III , D.D.S ., P.C .

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

THEODORE L. DEGENHARDT III , D.D.S ., P.C .

Doing business as

Degenhardt Dental

Practice address

2877 Crooks Rd Ste a
Troy, MI 48084-4717

Phone

(248) 643-6551

Fax

(248) 539-3538

NPI assigned

Oct 5, 2023

Last updated

Nov 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theodore L. Degenhardt III, DDSNPI 1508889924

Title

Owner

Phone

(248) 643-6551

Specialties & licenses 2

Addresses

Other names 1

• Degenhardt Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theodore Louis Degenhardt III, DDS

  • Dentist
  • Troy, MI
  • NPI 1508889924
  NPD (past) Authorized official
• Stephen Charles Degenhardt, DDS

  • Dentist
  • Troy, MI
  • NPI 1285120071
  NPD (past)

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1467232504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2877 CROOKS RD STE A",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844717",
            "telephone_number": "248-643-6551",
            "fax_number": "248-539-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2877 CROOKS RD STE A",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844717",
            "telephone_number": "248-643-6551",
            "fax_number": "248-539-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE L. DEGENHARDT III , D.D.S ., P.C .",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "DEGENHARDT",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-643-6551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Degenhardt Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Customized Equipment (DME) in Troy, MI
• Providers in Troy, MI by specialty
• Customized Equipment (DME) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.