Jason Thomas Pavlak, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901020399 Issued in MI

Practice address

725 N Milford Rd
Milford, MI 48381-1536

Phone

(248) 685-8748

NPI assigned

Jun 2, 2011

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

Practice roles

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.

• Madden Mulder & Andrews DDS PC

  • General Practice Dentistry
  • Milford, MI
  • NPI 1851470009
  NPD (past)

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1487948857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 PHEASANT RUN WEST DR",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483934544",
            "telephone_number": "248-624-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N MILFORD RD",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483811536",
            "telephone_number": "248-685-8748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLAK",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas John Ostrander, DDS
• Lisa Marie Paquette, LLMSW
• Michelle Parsons
• Parul Sanjay Patel
• Richi Patel
• Jennie Dare Chapman Payne, PA-C
• Pcor LLC
• Meghan Penn, PA-C
• Periodintic PLLC
• Linda Perrault

• General Practice Dentistry in Milford, MI
• Providers in Milford, 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 Jun 2, 2011; 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.