Individual provider Active NPI

Emily Marla Shwedel, D.D.S.

  • General Practice Dentistry
  • Plymouth, MI
National Provider Identifier
1487707998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17706 Issued in MI
Practice address
45270 Joy Rd
Plymouth, MI 48170-3941
Phone
(734) 453-9250
Fax
(734) 453-9295
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
No

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 17706 MI Primary

Addresses

Primary practice location

45270 Joy Rd
Plymouth, MI 48170-3941

Mailing address

45270 Joy Rd
Plymouth, MI 48170-3941
Phone (734) 453-9250

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
I20150713000562 MI Order and Referring Only - DentistPractitioner - Dentist 0941512412

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17706MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce Fisher DDS General Practice PastSince Jun 21, 2020 Accepting new patients
Adam K Stachler DDS PLLC General Practice PastSince Oct 27, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487707998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45270 JOY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703941",
            "telephone_number": "734-453-9250",
            "fax_number": "734-453-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45270 JOY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703941",
            "telephone_number": "734-453-9250",
            "fax_number": "734-453-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHWEDEL",
        "first_name": "EMILY",
        "middle_name": "MARLA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "17706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.