Individual provider Active NPI

Marc Steve Tarnopol, DDS

  • Dentist
  • West Bloomfield, MI
National Provider Identifier
1750300414
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14572 Issued in MI
Practice address
6615 Commerce Rd
West Bloomfield, MI 48324-2717
Phone
(248) 363-5600
NPI assigned
Jul 19, 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
Dentist 122300000X 14572 MI Primary

Addresses

Primary practice location

6615 Commerce Rd
West Bloomfield, MI 48324-2717

Mailing address

6615 Commerce Rd
West Bloomfield, MI 48324-2717
Phone (248) 363-5600

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
I20161207002010 MI Order and Referring Only - DentistPractitioner - Dentist 6608156732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14572MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750300414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 COMMERCE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483242717",
            "telephone_number": "248-363-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 COMMERCE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483242717",
            "telephone_number": "248-363-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARNOPOL",
        "first_name": "MARC",
        "middle_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "14572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.