Individual provider Active NPI

Patrick J Qatsha, DDS

  • General Practice Dentistry
  • Commerce TWP, MI
National Provider Identifier
1669569299
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018905 Issued in MI
Practice address
9555 Commerce Rd
Suite 1
Commerce TWP, MI 48382-4165
Phone
(248) 363-7121
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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 2901018905 MI Primary

Addresses

Primary practice location

9555 Commerce Rd
Suite 1
Commerce TWP, MI 48382-4165

Mailing address

9600 Commerce Rd
Commerce TWP, MI 48382-4111
Phone (248) 363-7121

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
I20150706001024 MI Order and Referring Only - DentistPractitioner - Dentist 8022320035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dream Dental Group PLLC General Practice CurrentSince May 6, 2006 Accepting new patients

Locations

9600 Commerce Rd
Commerce Twp, MI 48382
Phone (248) 363-7121

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1669569299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 COMMERCE RD",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483824111",
            "telephone_number": "248-363-7121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 COMMERCE RD",
            "address_2": "SUITE 1",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483824165",
            "telephone_number": "248-363-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QATSHA",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce TWP, MI

Sources for this page

Verify at the official NPI Registry.