Meredith Courtney Israel, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901018695 Issued in MI

Practice address

11885 E 12 Mile Rd
Warren, MI 48093-3474

Phone

(586) 574-9800

Fax

(248) 547-2291

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1467539015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 PINEHURST LN",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221965",
            "telephone_number": "702-355-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11885 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933474",
            "telephone_number": "586-574-9800",
            "fax_number": "248-547-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "MEREDITH",
        "middle_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490276",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Warren, MI
• Providers in Warren, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.