Individual provider Active NPI

Michael C Hutchison, DDS

  • Dentist
  • Traverse City, MI
National Provider Identifier
1710074695
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901016997 Issued in MI
Practice address
10850 E Traverse Hwy Ste 2250
Traverse City, MI 49684-1319
Phone
(231) 946-9644
Fax
(231) 946-9614
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901016997 MI Primary

Addresses

Primary practice location

10850 E Traverse Hwy Ste 2250
Traverse City, MI 49684-1319

Mailing address

10850 E Traverse Hwy Ste 2250
Traverse City, MI 49684-1319
Phone (231) 946-9644

Other identifiers 1

IdentifierTypeStateIssuer
1952860580OtherMIMED PIN

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
I20170727003700 MI Order and Referring Only - DentistPractitioner - Dentist 8325223175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2901016997MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1710074695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 E TRAVERSE HWY STE 2250",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496841319",
            "telephone_number": "231-946-9644",
            "fax_number": "231-946-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 E TRAVERSE HWY STE 2250",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496841319",
            "telephone_number": "231-946-9644",
            "fax_number": "231-946-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHISON",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED PIN",
            "identifier": "1952860580",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.