Individual provider Active NPI

Michael G Dillon, D.D.S.

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1700923497
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20335 Issued in OH
Practice address
1531 W Broad St
Columbus, OH 43222-1043
Phone
(614) 351-0555
Fax
(614) 351-0763
NPI assigned
Jan 31, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 20335 OH Primary

Addresses

Primary practice location

1531 W Broad St
Columbus, OH 43222-1043

Mailing address

1531 W Broad St
Columbus, OH 43222-1043
Phone (614) 351-0555

Other identifiers 1

IdentifierTypeStateIssuer
2274533MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170117002217 OH Practitioner - Oral Surgery 0749562213 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20335OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Mobile Medical Inc Current Accepting new patients
Mobile Medical, Inc. Past Accepting new patients
Jeffrey L. Wilden D.D.S.,Inc. General Practice Past Accepting new patients
Onsight, Inc. Past Accepting new patients

Locations

575 White Pond Dr
Ste A
Akron, OH 44320
Phone (330) 835-1629

3255 Levis Commons Blvd
Perrysburg, OH 43551
Phone (419) 874-0393

740 Commerce Dr
Ste A
Perrysburg, OH 43551
Phone 24852821166

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1700923497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221043",
            "telephone_number": "614-351-0555",
            "fax_number": "614-351-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221043",
            "telephone_number": "614-351-0555",
            "fax_number": "614-351-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "20335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2274533",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.