Individual provider Active NPI

Lindsey Elizabeth Wurtzel, D.D.S

  • Dentist
  • Ann Arbor, MI
National Provider Identifier
1710112172
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020016 Issued in MI
Practice address
4554 Washtenaw Ave
Ann Arbor, MI 48108-1000
Phone
(734) 971-2675
Fax
(734) 971-9653
NPI assigned
May 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020016 MI Primary

Addresses

Primary practice location

4554 Washtenaw Ave
Ann Arbor, MI 48108-1000

Mailing address

4554 Washtenaw Ave
Ann Arbor, MI 48108-1000
Phone (734) 971-2675

Other names 1

  • Dr. Lindsey Elizabeth Douville Other name

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
I20150514002019 MI Order and Referring Only - DentistPractitioner - Dentist 8527388545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020016MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Donald Wurtzel DDS PC Dentist 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.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1710112172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4554 WASHTENAW AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081000",
            "telephone_number": "734-971-2675",
            "fax_number": "734-971-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4554 WASHTENAW AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081000",
            "telephone_number": "734-971-2675",
            "fax_number": "734-971-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURTZEL",
        "first_name": "LINDSEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "DOUVILLE",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "D.D.S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.