Michael Lee Hetsko, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

58077 Issued in CA

Practice address

2933 University Ave
Riverside, CA 92507-4243

Phone

(951) 224-8230

Fax

(505) 784-6028

NPI assigned

Oct 3, 2005

Sex

Male

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 CA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.hetsko.p1@direct.chsica.nextgenshare.com

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.

• Community Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bloomington, CA
  • NPI 1952308009
  Medicare reassignment NPD (past)
• Community Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Fallbrook, CA
  • NPI 1982756086
  NPD
• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  NPD (past)

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1639166978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23477 BENDING OAK CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925623300",
            "telephone_number": "951-544-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 UNIVERSITY AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925074243",
            "telephone_number": "951-224-8230",
            "fax_number": "505-784-6028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22675 Alessandro Blvd",
            "address_purpose": "LOCATION",
            "city": "Moreno Valley",
            "state": "CA",
            "postal_code": "925538551",
            "country_code": "US",
            "telephone_number": "951-571-2365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HETSKO",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faye Elise Herrmann, LMFT
• Katherine Hert
• Kaylee Ann Heslep
• Kellie Hester
• Rosalind Marie Heth
• Joseph Archie Hetzel, RRW
• Kaila Hewitt
• Alisha Lee Hewko, DDS
• Chiara Heyer
• Rayvan Elaine Hibbs

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.