Individual provider Active NPI

Robert Callisto Gasparotto, DDS

  • General Practice Dentistry
  • Canton, MI
National Provider Identifier
1497825962
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
014843 Issued in MI
Practice address
5958 N Canton Center Rd
Ste 600
Canton, MI 48187-2765
Phone
(734) 459-1950
Fax
(734) 459-5710
NPI assigned
Nov 9, 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
General Practice Dentistry 1223G0001X 014843 MI Primary

Addresses

Primary practice location

5958 N Canton Center Rd
Ste 600
Canton, MI 48187-2765

Mailing address

5958 N Canton Center Rd
Ste 600
Canton, MI 48187-2765
Phone (734) 459-1950

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
I20190715001475 MI Practitioner - Dentist 8628370905 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014843MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mortiere and Gasparotto DDS PC General Practice CurrentSince Jul 8, 2007 Accepting new patients

Locations

5958 N Canton Center Rd
Ste 600
Canton, MI 48187
Phone (734) 459-1950

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497825962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5958 N CANTON CENTER RD",
            "address_2": "STE 600",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872765",
            "telephone_number": "734-459-1950",
            "fax_number": "734-459-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5958 N CANTON CENTER RD",
            "address_2": "STE 600",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872765",
            "telephone_number": "734-459-1950",
            "fax_number": "734-459-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASPAROTTO",
        "first_name": "ROBERT",
        "middle_name": "CALLISTO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "014843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.