Bruce S Sherizen, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12960 Issued in MI

Practice address

18263 Fort St
Riverview, MI 48193-7434

Phone

(734) 284-2620

Fax

(734) 284-4290

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477663813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18263 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937434",
            "telephone_number": "734-284-2620",
            "fax_number": "734-284-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18263 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937434",
            "telephone_number": "734-284-2620",
            "fax_number": "734-284-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIZEN",
        "first_name": "BRUCE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolene Marie Scott
• Avtar S Sekhon, MD
• Steven John Serra, D.O.
• Mary Susan Servey, RN,MSN, MSA,B-C
• Deeb Shalhoub, MD
• Kristine V Sherwood, RPH
• Joseph Anthony Shusteric, D.C.
• Simpson Holzworth (David G Holzworth DO PC)
• Patricia D Sims-Brown, LPC-S
• Margaret Ann Skaggs

• General Practice Dentistry in Riverview, MI
• Providers in Riverview, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.