Individual provider Active NPI

Gregory Alan Yassick, D.D.S.

  • General Practice Dentistry
  • Flint, MI
National Provider Identifier
1710034863
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13640 Issued in MI
Practice address
G3163 Flushing Rd
Flint, MI 48504-4365
Phone
(810) 233-4354
Fax
(810) 233-4488
NPI assigned
Jan 4, 2007
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 13640 MI Primary

Addresses

Primary practice location

G3163 Flushing Rd
Flint, MI 48504-4365

Mailing address

669 Bending Brook Dr.
Flushing, MI 48433
Phone (810) 659-7657

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
I20161227000809 MI Order and Referring Only - DentistPractitioner - Dentist 0648551085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13640MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory a Yassick, D.D.S. General Practice Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710034863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 BENDING BROOK DR.",
            "city": "FLUSHING",
            "state": "MI",
            "postal_code": "48433",
            "telephone_number": "810-659-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3163 FLUSHING RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485044365",
            "telephone_number": "810-233-4354",
            "fax_number": "810-233-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSICK",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.