Rutuja Hambirrao Jadhav, MS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2335 Pontiac Lake Rd Ste D
Waterford, MI 48328-2761

Phone

(248) 683-2300

NPI assigned

Oct 2, 2021

Last updated

Oct 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

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.

• Endodontic Associates of Michigan PLLC

  • Endodontics
  • Waterford, MI
  • NPI 1164479101
  NPD

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

{
    "created_epoch": "1633132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1619649100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 PONTIAC LAKE RD STE D42160",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282761",
            "telephone_number": "248-683-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 PONTIAC LAKE RD STE D",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282761",
            "telephone_number": "248-683-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADHAV",
        "first_name": "RUTUJA",
        "middle_name": "HAMBIRRAO",
        "name_prefix": "Dr.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-02",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desmond Alexander Jackson, M.D.
• Maia J Jackson
• Salashia Jackson
• Jibu Jacob
• Jacqueline C Vaughn DC PC
• Jerome Alan Jaffee, DDS
• Jallow Kia Enterprise LLC
• Alieu Essa Jallow
• James a. Gibson, M.D., P.C.
• James E. Locascio, D.D.S.P.C.

• Student in an Organized Health Care Education/Training Program in Waterford, MI
• Providers in Waterford, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.