NPIMap

Organization Active NPI

Robert Bruce Macintosh D.D.S., P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Bingham Farms, MI
National Provider Identifier
1649371543
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
007491 Issued in MI
Legal business name
ROBERT BRUCE MACINTOSH D.D.S., P.C.
Practice address
31100 Telegraph Rd
Suite 100
Bingham Farms, MI 48025-4363
Phone
(248) 642-2115
Fax
(248) 642-6387
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Bruce Macintosh, D.D.S.NPI 1538260427
Title
President
Phone
(248) 642-2115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 007491 MI Primary

Addresses

Primary practice location

31100 Telegraph Rd
Suite 100
Bingham Farms, MI 48025-4363

Mailing address

31100 Telegraph Rd
Suite 100
Bingham Farms, MI 48025-4363
Phone (248) 642-2115

Other identifiers 2

IdentifierTypeStateIssuer
4007538OtherMIMEDICAID DENTAL
2996322MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1649371543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31100 TELEGRAPH RD",
            "address_2": "SUITE 100",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254363",
            "telephone_number": "248-642-2115",
            "fax_number": "248-642-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31100 TELEGRAPH RD",
            "address_2": "SUITE 100",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254363",
            "telephone_number": "248-642-2115",
            "fax_number": "248-642-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT BRUCE MACINTOSH D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "MACINTOSH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-642-2115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "007491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DENTAL",
            "identifier": "4007538",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2996322",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.