Individual provider Active NPI

Joseph William Robertson, DDS

  • General Practice Dentistry
  • Troy, MI
National Provider Identifier
1740294768
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13810 Issued in MI
Practice address
1551 W Big Beaver Rd
Ste D-14
Troy, MI 48084-3528
Phone
(248) 643-7530
Fax
(248) 643-7533
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

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 13810 MI Primary

Addresses

Primary practice location

1551 W Big Beaver Rd
Ste D-14
Troy, MI 48084-3528

Mailing address

1551 W Big Beaver Rd
Ste D-14
Troy, MI 48084-3528
Phone (248) 643-7530

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
I20150602000521 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2264452887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13810MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740294768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 W BIG BEAVER RD",
            "address_2": "STE D-14",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843528",
            "telephone_number": "248-643-7530",
            "fax_number": "248-643-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 W BIG BEAVER RD",
            "address_2": "STE D-14",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843528",
            "telephone_number": "248-643-7530",
            "fax_number": "248-643-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "13810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.