Michael Samuel Perez, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009775 Issued in IN

Practice address

625 Ridge Rd Ste B
Munster, IN 46321-1695

Phone

(219) 836-5787

Fax

(219) 836-4823

NPI assigned

Jan 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 IN

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

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.

• Michael S. Perez D.D.S., P.C.

  • General Practice Dentistry
  • Munster, IN
  • NPI 1013066448
  NPD (past) Authorized official

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649327867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 RIDGE RD STE B",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211695",
            "telephone_number": "219-836-5787",
            "fax_number": "219-836-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 RIDGE RD STE B",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211695",
            "telephone_number": "219-836-5787",
            "fax_number": "219-836-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MICHAEL",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah T Payne, D.C.
• Richard J Peach, O.D.
• Katie Peksenak, PA-C
• Russell W Pellar, MD
• Stephanie Gail Penacho, PMHNP
• Omar M Perez, M.D.
• Katie Persenaire
• Doreen Marie Peterson, D.D.S.
• Rachel Ann Peterson, DDS
• Ronald D. Peterson, D.O.

• General Practice Dentistry in Munster, IN
• Providers in Munster, IN by specialty
• General Practice Dentistry in Indiana

• 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.
• 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.