Individual provider Active NPI

Nicole Marie Jane, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Livonia, MI
National Provider Identifier
1750319067
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2901017533 Issued in MI
Practice address
33627 7 Mile Rd
Livonia, MI 48152-3077
Phone
(248) 471-1555
Fax
(248) 471-4146
NPI assigned
Jun 28, 2006
Last updated
Aug 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 53320 CA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X S3-144 NV
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2901017533 MI Primary

Addresses

Primary practice location

33627 7 Mile Rd
Livonia, MI 48152-3077

Mailing address

33627 7 Mile Rd
Livonia, MI 48152-3077
Phone (248) 471-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
53320CAMDOrthodontics and Dentofacial Orthopedic Dentist
2901017533MIMDOrthodontics and Dentofacial Orthopedic Dentist
S3-144NVMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Epic4 Specialty Partners of Michigan, PLLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients

Locations

33627 7 Mile Rd
Livonia, MI 48152
Phone (248) 471-1555

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1750319067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33627 7 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523077",
            "telephone_number": "248-471-1555",
            "fax_number": "248-471-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33627 7 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523077",
            "telephone_number": "248-471-1555",
            "fax_number": "248-471-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "53320",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "S3-144",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901017533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.