Active NPI
Mark Dylewski, D.D.S.
- Endodontics
- Rochester Hills, MI
National Provider Identifier
1689614877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 14842
- Practice address
- 1460 Walton Blvd
Suite 208
Rochester Hills, MI 48309-1768 - Phone
- (248) 656-1626
- Fax
- (248) 656-3147
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 14842 | MI | Primary |
Addresses
Primary practice location
1460 Walton Blvd
Suite 208
Rochester Hills, MI 48309-1768
Mailing address
1460 Walton Blvd
Suite 208
Rochester Hills, MI 48309-1768
Phone (248) 656-1626
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160205002219 | MI | Order and Referring Only - Dentist | 3072561935 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14842 | MI | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endodontic Associates of Michigan PLLC | Endodontics | Past | Accepting new patients |
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.
-
- Endodontics
- Rochester Hills, MI
- NPI 1699721910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454284800000",
"number": "1689614877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1460 WALTON BLVD",
"address_2": "SUITE 208",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483091768",
"telephone_number": "248-656-1626",
"fax_number": "248-656-3147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1460 WALTON BLVD",
"address_2": "SUITE 208",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483091768",
"telephone_number": "248-656-1626",
"fax_number": "248-656-3147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYLEWSKI",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2016-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MI",
"license": "14842",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rochester Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.