Individual provider Active NPI

Arthur Aaron Sonneborn, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jackson, MI
National Provider Identifier
1497766703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
014300 Issued in MI
Practice address
1415 W Argyle St
Jackson, MI 49202-1978
Phone
(517) 787-9833
Fax
(517) 787-9350
NPI assigned
Aug 11, 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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 014300 MI Primary

Addresses

Primary practice location

1415 W Argyle St
Jackson, MI 49202-1978

Mailing address

118 Hazel Ave
East Leroy, MI 49051-9744
Phone (269) 979-2619

Other identifiers 1

IdentifierTypeStateIssuer
3375235MedicaidMI

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
014300MIMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Arthur Sonneborn DDS Orthodontics and Dentofacial Orthopedics 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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497766703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 HAZEL AVE",
            "city": "EAST LEROY",
            "state": "MI",
            "postal_code": "490519744",
            "telephone_number": "269-979-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 W ARGYLE ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021978",
            "telephone_number": "517-787-9833",
            "fax_number": "517-787-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNEBORN",
        "first_name": "ARTHUR",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "014300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3375235",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, 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.