Jessica Marie Joseph, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022311 Issued in MI

Practice address

4855 W Centre Ave
Portage, MI 49024-4686

Phone

(269) 375-0800

NPI assigned

Jun 15, 2017

Last updated

Feb 10, 2021By the provider in NPPES

Sex

Female

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jessica Joseph DDS PLLC

  dba Centre Smiles Dental

  • Dentist
  • Portage, MI
  • NPI 1023961570
  NPD Authorized official
• Joseph Dental Group

  dba Centre Smiles Dental Paw Paw

  • General Practice Dentistry
  • Paw Paw, MI
  • NPI 1124970678
  NPD Authorized official

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1528598158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244686",
            "telephone_number": "269-375-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244686",
            "telephone_number": "269-375-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Haggerty Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483232184",
            "country_code": "US",
            "telephone_number": "248-624-0008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Timothy Jones, D.O.
• Seth Howard Jones, DIPL. AC.
• Thomas Jones, RPA C
• Miya Jordan
• Hannah Rose Joseph, LLMSW, MT-BC
• Renu Joseph
• Joy Unlimited Counseling Center, PLC
• Karen Joy, LCSW
• Cynthia Wolf Jubenville, LMSW
• Jennifer Jurado

• General Practice Dentistry in Portage, MI
• Providers in Portage, 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 Feb 10, 2021; 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.