Michael J Marderosian, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16156 Issued in MI

Practice address

29877 Telegraph Rd Ste L-12
Southfield, MI 48034-7657

Phone

(248) 352-7722

NPI assigned

May 15, 2007

Last updated

Apr 4, 2018By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Farmbrook Dental Group PC

  • General Practice Dentistry
  • Bloomfield Hills, MI
  • NPI 1740214683
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1730395864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 TELEGRAPH RD SUITE 1500",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48301",
            "telephone_number": "248-855-0824",
            "fax_number": "248-855-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD STE L-12",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347657",
            "telephone_number": "248-352-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDEROSIAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Marciniak, MA CCC-SLP
• Amanda Jane Marcozzi, P.A.
• Iyana Marcus
• Roslyn Kaye Marcy, LPC
• Jeffery C Marderosian, D.D.S.
• Judith Ellen Margerum, PH.D.
• Lynn J Margolis
• Marina Physical Therapy
• Carol Ann Marine
• Alison E Maringo, MD

• General Practice Dentistry in Southfield, MI
• Providers in Southfield, 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 Apr 4, 2018; 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.