Randy J Allain, D.D.S, F.A.G.D, F.I.

Individual provider Active NPI General Practice Dentistry · Highland, MI

NPI 1467510404 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1467510404
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2901014545 (MI)
Practice address
1733 S Milford Rd
Highland, MI 48357-4870
Phone
(248) 887-3300
Fax
(248) 887-9711
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161206001325 MI Order and Referring Only - Dentist
Practitioner - Dentist
2163702317

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Fortson Dentistry Milford P.C. Past
since Sep 28, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901014545 MI Yes

Addresses

Primary practice location

1733 S Milford Rd
Highland, MI 48357-4870

Mailing address

1733 S Milford Rd
Highland, MI 48357-4870
Phone (248) 887-3300

Other providers in Highland, MI

All providers in Highland, MI · General Practice Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.