Individual provider Active NPI

Mindy Sue Salzberg-Siegel, DDS, PC

  • General Practice Dentistry
  • Clinton TWP, MI
National Provider Identifier
1649325531
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
013815 Issued in MI
Practice address
38550 Garfield Rd
Suite C.
Clinton TWP, MI 48038-3406
Phone
(586) 416-1444
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 013815 MI Primary

Addresses

Primary practice location

38550 Garfield Rd
Suite C.
Clinton TWP, MI 48038-3406

Mailing address

765 S Glenhurst Dr
Birmingham, MI 48009-2934
Phone (248) 644-7959

Other identifiers 1

IdentifierTypeStateIssuer
778716OtherMIUNITED CONCORDIA PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013815MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rabban-Acho Dental PLLC General Practice PastSince Apr 17, 2020 Accepting new patients
Mindy Salzberg-Siegel DDS PC PastSince Feb 10, 1992 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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649325531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 S GLENHURST DR",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480092934",
            "telephone_number": "248-644-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38550 GARFIELD RD",
            "address_2": "SUITE C.",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383406",
            "telephone_number": "586-416-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALZBERG-SIEGEL",
        "first_name": "MINDY",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DDS, PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "013815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "778716",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.