Angela Lynn Harrell, DDS

Individual provider Active NPI General Practice Dentistry · Ortonville, MI

NPI 1669608261 · NPPES record last updated Jan 15, 2015

Key facts

NPI
1669608261
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2901020788 (MI)
Practice address
1201 S Ortonville Rd
Ortonville, MI 48462-7600
Phone
(248) 762-4850
NPI assigned
Jun 9, 2009
Sex
Female
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
I20170103000115 MI Order and Referring Only - Dentist
Practitioner - Dentist
7012298243

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2901020788MIMDGeneral Practice Dentistry
055384NYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901020788 MI Yes
Dentist 122300000X 57713 CA
General Practice Dentistry 1223G0001X 055384 NY

Addresses

Primary practice location

1201 S Ortonville Rd
Ortonville, MI 48462-7600

Mailing address

1201 S Ortonville Rd
Ortonville, MI 48462-7600
Phone (248) 762-4850

Other names

  • Dr. Angela Lynn Wojtkowicz Former name

Other providers in Ortonville, MI

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

Sources for this page

Verify at the official NPI Registry.