Individual provider Active NPI

Donald Schwartzfisher, D.D.S

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1710090808
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901015628 Issued in MI
Practice address
101 Sheldon Blvd SE
Grand Rapids, MI 49503-4262
Phone
(616) 776-2340
Fax
(616) 776-2341
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

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 2901015628 MI Primary

Addresses

Primary practice location

101 Sheldon Blvd SE
Grand Rapids, MI 49503-4262

Mailing address

550 Cherry St SE
Grand Rapids, MI 49503-4748
Phone (616) 235-7280

Other identifiers 3

IdentifierTypeStateIssuer
4525337MedicaidMI
3346510MedicaidMI
2774164MedicaidMI

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
I20160223001101 MI Order and Referring Only - DentistPractitioner - Dentist 5597060970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: donald.schwartzfisher.p1@direct.cherryhealth.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710090808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 CHERRY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034748",
            "telephone_number": "616-235-7280",
            "fax_number": "616-752-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SHELDON BLVD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034262",
            "telephone_number": "616-776-2340",
            "fax_number": "616-776-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZFISHER",
        "first_name": "DONALD",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4525337",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3346510",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2774164",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.