Individual provider Active NPI

Gary M Fiteny, DDS PC

  • General Practice Dentistry
  • Clarkston, MI
National Provider Identifier
1619934510
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901015504 Issued in MI
Practice address
8080 Ortonville Rd
Suite a
Clarkston, MI 48348-4456
Phone
(248) 620-2933
Fax
(248) 620-5055
NPI assigned
Apr 26, 2006
Last updated
Jul 13, 2026By the provider in NPPES
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
General Practice Dentistry 1223G0001X 2901015504 MI Primary

Addresses

Primary practice location

8080 Ortonville Rd
Suite a
Clarkston, MI 48348-4456

Mailing address

5635 Sashabaw Rd
Suite a
Clarkston, MI 48346-3149
Phone (248) 620-2933

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
I20160314001301 MI Order and Referring Only - DentistPractitioner - Dentist 7416253638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619934510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 SASHABAW RD",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463149",
            "telephone_number": "248-620-2933",
            "fax_number": "248-620-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 ORTONVILLE RD",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483484456",
            "telephone_number": "248-620-2933",
            "fax_number": "248-620-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITENY",
        "first_name": "GARY",
        "middle_name": "M",
        "credential": "DDS PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.