Individual provider Active NPI

Jennifer Murri, DDS

  • Dentist
  • Lincoln Park, MI
National Provider Identifier
1578827036
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020638 Issued in MI
Practice address
1359 Champaign
Lincoln Park, MI 48146
Phone
(313) 386-9660
Fax
(313) 386-5515
NPI assigned
Jun 29, 2012
Last updated
Jun 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020638 MI Primary

Addresses

Primary practice location

1359 Champaign
Lincoln Park, MI 48146

Mailing address

1359 Champaign
Lincoln Park, MI 48146
Phone (313) 386-9660

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
I20150223000070 MI Order and Referring Only - DentistPractitioner - Dentist 1456676121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Dental Clinic PC Past Accepting new patients
Galayda & Shackleford DDS PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1578827036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 CHAMPAIGN",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "48146",
            "telephone_number": "313-386-9660",
            "fax_number": "313-386-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 CHAMPAIGN",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "48146",
            "telephone_number": "313-386-9660",
            "fax_number": "313-386-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRI",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, MI

Sources for this page

Verify at the official NPI Registry.