Individual provider Active NPI

Michael Glass, D.D.S.

  • Endodontics
  • Rochester Hills, MI
National Provider Identifier
1609816644
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
10551 Issued in MI
Practice address
1460 Walton Blvd
Suite 208
Rochester Hills, MI 48309-1768
Phone
(284) 656-1626
Fax
(248) 656-3147
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 10551 MI Primary

Addresses

Primary practice location

1460 Walton Blvd
Suite 208
Rochester Hills, MI 48309-1768

Mailing address

1460 Walton Blvd
Suite 208
Rochester Hills, MI 48309-1768
Phone (284) 656-1626

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
I20161014001100 MI Order and Referring Only - DentistPractitioner - Dentist 9234187196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10551MIMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontic Associates of Michigan PLLC Endodontics PastSince Mar 11, 2025 Accepting new patients

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609816644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 WALTON BLVD",
            "address_2": "SUITE 208",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091768",
            "telephone_number": "284-656-1626",
            "fax_number": "248-656-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 WALTON BLVD",
            "address_2": "SUITE 208",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091768",
            "telephone_number": "284-656-1626",
            "fax_number": "248-656-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "10551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.