Individual provider Active NPI

Steven Anthony Sulfaro, D.D.S.

  • General Practice Dentistry
  • Holly, MI
National Provider Identifier
1659594794
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901014150 Issued in MI
Practice address
607 N Saginaw St
Holly, MI 48442-1344
Phone
(248) 634-4674
NPI assigned
Apr 10, 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 2901014150 MI Primary

Addresses

Primary practice location

607 N Saginaw St
Holly, MI 48442-1344

Mailing address

607 N Saginaw St
Holly, MI 48442-1344
Phone (248) 634-4674

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
I20181228000169 MI Order and Referring Only - DentistPractitioner - Dentist 9537404215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901014150MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659594794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 N SAGINAW ST",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484421344",
            "telephone_number": "248-634-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 N SAGINAW ST",
            "city": "HOLLY",
            "state": "MI",
            "postal_code": "484421344",
            "telephone_number": "248-634-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULFARO",
        "first_name": "STEVEN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly, MI

Sources for this page

Verify at the official NPI Registry.