Individual provider Active NPI

Heidi Rebecca Merritt, D.D.S.

  • General Practice Dentistry
  • Royal Oak, MI
National Provider Identifier
1740696228
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901021318 Issued in MI
Practice address
1010 N Campbell Rd
Royal Oak, MI 48067-1570
Phone
(248) 542-9700
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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 2901021318 MI Primary

Addresses

Primary practice location

1010 N Campbell Rd
Royal Oak, MI 48067-1570

Mailing address

95 Virginia St
Pontiac, MI 48342-1375
Phone (248) 212-6017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150923001328 MI Order and Referring Only - DentistPractitioner - Dentist 7012224041
I20160115002095 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012224041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021318MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404691200000",
    "number": "1740696228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 VIRGINIA ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421375",
            "telephone_number": "248-212-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N CAMPBELL RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671570",
            "telephone_number": "248-542-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "HEIDI",
        "middle_name": "REBECCA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.