Gregory John Pine, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15702 Issued in MI

Practice address

49095 Schoenherr
Shelby TWP, MI 48315

Phone

(586) 726-8350

Fax

(586) 731-3965

NPI assigned

Feb 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720113384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49433 COMPASS PTE DRIVE",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "48047",
            "telephone_number": "586-716-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49095 SCHOENHERR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "48315",
            "telephone_number": "586-726-8350",
            "fax_number": "586-731-3965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINE",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "15702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Marie Persha, MA LPC CACII
• Laura Marie Pettibone
• Pharmascript of Shelby Inc
• Patricia Anne Pich, PH.D., LPC
• Sarah Goswami Piet
• Pinpoint Wellness Center, PC
• Pointe Family Dentistry-Shelby PLLC
• Catherine Polito, FNP
• Chris Polyzois, DPT
• David Pomaville

• General Practice Dentistry in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.