Individual provider Active NPI

Dennis Donoho, D.D.S.

  • General Practice Dentistry
  • Ypsilanti, MI
National Provider Identifier
1649486267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901012331 Issued in MI
Practice address
2100 Washtenaw Rd
Ypsilanti, MI 48197-1708
Phone
(734) 485-4600
Fax
(734) 485-4601
NPI assigned
May 14, 2007
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 2901012331 MI Primary

Addresses

Primary practice location

2100 Washtenaw Rd
Ypsilanti, MI 48197-1708

Mailing address

2100 Washtenaw Rd
Ypsilanti, MI 48197-1708
Phone (734) 485-4600

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
I20150619000346 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8628389467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901012331MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649486267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WASHTENAW RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971708",
            "telephone_number": "734-485-4600",
            "fax_number": "734-485-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WASHTENAW RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971708",
            "telephone_number": "734-485-4600",
            "fax_number": "734-485-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOHO",
        "first_name": "DENNIS",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901012331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.