Individual provider Active NPI

Rachel Marie Weatherhead, D.D.S.

  • Dentist
  • Woodhaven, MI
National Provider Identifier
1609258748
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021615 Issued in MI
Practice address
22150 Allen Rd Ste 1
Woodhaven, MI 48183-2271
Phone
(734) 363-8143
NPI assigned
Jun 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021615 MI Primary

Addresses

Primary practice location

22150 Allen Rd Ste 1
Woodhaven, MI 48183-2271

Mailing address

22150 Allen Rd
Woodhaven, MI 48183-2271
Phone (734) 676-6672

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
I20160516000774 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6608165642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021615MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rachel M Weatherhead DDS PLLC Dentist CurrentSince Nov 30, 2020 Accepting new patients

Locations

22150 Allen Rd
Ste 1
Woodhaven, MI 48183
Phone (734) 363-8143

22150 Allen Rd
Woodhaven, MI 48183
Phone (734) 675-1520

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1609258748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22150 ALLEN RD",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481832271",
            "telephone_number": "734-676-6672",
            "fax_number": "734-676-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22150 ALLEN RD STE 1",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481832271",
            "telephone_number": "734-363-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERHEAD",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, MI

Sources for this page

Verify at the official NPI Registry.