Scott A Forsmark, DDS

Individual provider Active NPI General Practice Dentistry · Cheboygan, MI

NPI 1669415469 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1669415469
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2901015437 (MI)
Practice address
1346 Mackinaw Ave
Cheboygan, MI 49721-1003
Phone
(231) 627-5681
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151106000778 MI Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
7113237991

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901015437 MI Yes

Addresses

Primary practice location

1346 Mackinaw Ave
Cheboygan, MI 49721-1003

Mailing address

1346 Mackinaw Ave
Cheboygan, MI 49721-1003
Phone (231) 627-5681

Other providers in Cheboygan, MI

All providers in Cheboygan, MI · General Practice Dentistry in Michigan

Sources for this page

Verify at the official NPI Registry.