Individual provider Active NPI

Michael Steven Zonder, D.D.S.

  • General Practice Dentistry
  • Farmington Hills, MI
National Provider Identifier
1609925080
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9389 Issued in MI
Practice address
25882 Orchard Lake Rd
Suite 107
Farmington Hills, MI 48336-1292
Phone
(248) 476-8330
Fax
(248) 476-9236
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9389 MI Primary

Addresses

Primary practice location

25882 Orchard Lake Rd
Suite 107
Farmington Hills, MI 48336-1292

Mailing address

25882 Orchard Lake Rd
Suite 107
Farmington Hills, MI 48336-1292
Phone (248) 476-8330

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
I20150608001181 MI Order and Referring Only - DentistPractitioner - Dentist 8820319460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9389MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609925080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25882 ORCHARD LAKE RD",
            "address_2": "SUITE 107",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361292",
            "telephone_number": "248-476-8330",
            "fax_number": "248-476-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25882 ORCHARD LAKE RD",
            "address_2": "SUITE 107",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361292",
            "telephone_number": "248-476-8330",
            "fax_number": "248-476-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZONDER",
        "first_name": "MICHAEL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "9389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.