Individual provider Active NPI

Daniel G. Campbell, DDS

  • General Practice Dentistry
  • Livonia, MI
National Provider Identifier
1669570396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901012376 Issued in MI
Practice address
14600 Farmington Rd
Suite 102
Livonia, MI 48154-5463
Phone
(734) 522-5580
Fax
(734) 522-0682
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

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 2901012376 MI Primary

Addresses

Primary practice location

14600 Farmington Rd
Suite 102
Livonia, MI 48154-5463

Mailing address

14600 Farmington Rd
Suite 102
Livonia, MI 48154-5463
Phone (734) 522-5580

Other identifiers 1

IdentifierTypeStateIssuer
1656729MedicaidMI

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
I20160126002680 MI Order and Referring Only - DentistPractitioner - Dentist 2860795705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901012376MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669570396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14600 FARMINGTON RD",
            "address_2": "SUITE 102",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545463",
            "telephone_number": "734-522-5580",
            "fax_number": "734-522-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14600 FARMINGTON RD",
            "address_2": "SUITE 102",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545463",
            "telephone_number": "734-522-5580",
            "fax_number": "734-522-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DANIEL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901012376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1656729",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.