Individual provider Active NPI

Allan Jeffrey Oleinick, D.D.S

  • General Practice Dentistry
  • Saint Clair Shores, MI
National Provider Identifier
1629288469
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901013562 Issued in MI
Practice address
25915 Harper Ave
Suite F
Saint Clair Shores, MI 48081-3770
Phone
(586) 776-5945
Fax
(586) 776-5948
NPI assigned
May 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 2901013562 MI Primary

Addresses

Primary practice location

25915 Harper Ave
Suite F
Saint Clair Shores, MI 48081-3770

Mailing address

25915 Harper Ave
Suite F
Saint Clair Shores, MI 48081-3770
Phone (586) 776-5945

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
I20161031001380 MI Order and Referring Only - DentistPractitioner - Dentist 5092843441

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Dental General Practice Past Accepting new patients
Allan J. Oleinick D.D.S P.C. General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629288469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25915 HARPER AVE",
            "address_2": "SUITE F",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813770",
            "telephone_number": "586-776-5945",
            "fax_number": "586-776-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25915 HARPER AVE",
            "address_2": "SUITE F",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813770",
            "telephone_number": "586-776-5945",
            "fax_number": "586-776-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLEINICK",
        "first_name": "ALLAN",
        "middle_name": "JEFFREY",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.