Theodore Louis Degenhardt III, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12268 Issued in MI

Practice address

2877 Crooks Rd
Suite a
Troy, MI 48084-4717

Phone

(248) 643-6551

NPI assigned

Jul 26, 2006

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.

• Theodore L. Degenhardt III , D.D.S ., P.C .

  • Customized Equipment (DME)
  • Troy, MI
  • NPI 1467232504
  NPD (past) Authorized official

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1508889924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2877 CROOKS RD",
            "address_2": "SUITE A",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844717",
            "telephone_number": "248-643-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2877 CROOKS RD",
            "address_2": "SUITE A",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844717",
            "telephone_number": "248-643-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENHARDT",
        "first_name": "THEODORE",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "12268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Marie Dedona
• Dee Davis Inc.
• Ahmad Deebajah
• Anne Marie Degener
• Stephen Charles Degenhardt, DDS
• Elizabeth Delandsheer, LPC
• Christine Delange, PH.D.
• Delphi Corporation
• Erlinda Delpilar, MD
• Theresa M Delpup-Smith

• Dentist in Troy, MI
• Providers in Troy, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.