Individual provider Active NPI

John Frederick Sivertson, DDS MS

  • Dentist
  • Livonia, MI
National Provider Identifier
1487740866
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10031 Issued in MI
Practice address
31636 Schoolcraft
Livonia, MI 48150
Phone
(734) 522-7313
Fax
(734) 522-3203
NPI assigned
Oct 5, 2006
Sex
Male
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
Dentist 122300000X 10031 MI Primary

Addresses

Primary practice location

31636 Schoolcraft
Livonia, MI 48150

Mailing address

31636 Schoolcraft
Livonia, MI 48150
Phone (734) 522-7313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
10031MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Frederic N. Smith,D.D.S, M.S. & John F. Sivertson, D.D.S, M.S., P.C. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487740866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31636 SCHOOLCRAFT",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48150",
            "telephone_number": "734-522-7313",
            "fax_number": "734-522-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31636 SCHOOLCRAFT",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48150",
            "telephone_number": "734-522-7313",
            "fax_number": "734-522-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVERTSON",
        "first_name": "JOHN",
        "middle_name": "FREDERICK",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "10031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.