Individual provider Active NPI

Joanne Dawley, D.D.S.

  • General Practice Dentistry
  • Southfield, MI
National Provider Identifier
1477676039
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12472 Issued in MI
Practice address
16315 W 12 Mile Rd
Southfield, MI 48076-2913
Phone
(248) 443-1600
Fax
(248) 443-4939
NPI assigned
Apr 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 12472 MI Primary

Addresses

Primary practice location

16315 W 12 Mile Rd
Southfield, MI 48076-2913

Mailing address

16315 W 12 Mile Rd
Southfield, MI 48076-2913
Phone (248) 443-1600

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151223000269 MI Order and Referring Only - Other (Non-Physician) 0840591558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12472MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Joanne Dawley CurrentSince Nov 15, 2020 Accepting new patients

Locations

16315 W 12 Mile Rd
Southfield, MI 48076
Phone (248) 443-1600

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, 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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477676039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16315 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762913",
            "telephone_number": "248-443-1600",
            "fax_number": "248-443-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16315 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762913",
            "telephone_number": "248-443-1600",
            "fax_number": "248-443-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWLEY",
        "first_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.