Individual provider Active NPI

Joshua John Joshua, DDS

  • General Practice Dentistry
  • Muskegon Heights, MI
National Provider Identifier
1467464800
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18282 Issued in MI
Practice address
2700 Baker St
3Rd Floor
Muskegon Heights, MI 49444-2157
Phone
(231) 737-8603
Fax
(231) 737-9012
NPI assigned
Aug 13, 2006
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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 18282 MI Primary

Addresses

Primary practice location

2700 Baker St
3Rd Floor
Muskegon Heights, MI 49444-2157

Mailing address

2700 Baker St
3Rd Floor
Muskegon Heights, MI 49444-2157
Phone (231) 737-8603

Other identifiers 4

IdentifierTypeStateIssuer
4379210MedicaidMI
88144OtherMIDELTA
00D8002810OtherMIBCBS
2901018282MedicaidMI

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
I20230324002561 MI Practitioner - Dentist 2264806603 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18282MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hackley Community Care Center, Inc CurrentSince Dec 23, 2022 Accepting new patients
Hackley Community Care Center Inc CurrentSince Dec 23, 2022 Accepting new patients

Locations

376 E Apple Ave
Muskegon, MI 49442
Phone (231) 724-3699

2700 Baker St
Fl 3
Muskegon Heights, MI 49444
Phone (231) 733-6607

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, 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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1467464800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST",
            "address_2": "3RD FLOOR",
            "city": "MUSKEGON HEIGHTS",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-8603",
            "fax_number": "231-737-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST",
            "address_2": "3RD FLOOR",
            "city": "MUSKEGON HEIGHTS",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-8603",
            "fax_number": "231-737-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSHUA",
        "first_name": "JOSHUA",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4379210",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "88144",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00D8002810",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2901018282",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon Heights, MI

Sources for this page

Verify at the official NPI Registry.