Joseph A Carlu, DDS

Individual provider Active NPI Dentist · Atlanta, MI

NPI 1720201486 · NPPES record last updated Jan 27, 2017

Key facts

NPI
1720201486
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
JC009488 (MI)
Practice address
11899 M 32
Atlanta, MI 49709-9374
Phone
(989) 785-4855
Fax
(989) 785-2267
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150603002264 MI Order and Referring Only - Dentist
Practitioner - Dentist
2466773346

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
JC009488MIMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X JC009488 MI Yes

Addresses

Primary practice location

11899 M 32
Atlanta, MI 49709-9374

Mailing address

PO Box 427
Hillman, MI 49746-0427
Phone (989) 354-2197

Other providers in Atlanta, MI

All providers in Atlanta, MI · Dentist in Michigan

Sources for this page

Verify at the official NPI Registry.