Todd Gillan, DDS
Individual provider Active NPI General Practice Dentistry · Lowell, MI
NPI 1760596290 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1760596290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2901012791 (MI)
- Practice address
- 2186 W Main St
Lowell, MI 49331-8637 - Phone
- (616) 897-8491
- Fax
- (616) 897-8350
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170228000055 | MI | Order and Referring Only - Dentist |
6305120924 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901012791 | MI | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901012791 | MI | Yes |
Addresses
Primary practice location
2186 W Main St
Lowell, MI 49331-8637
Mailing address
2186 W Main St
Lowell, MI 49331-8637
Phone (616) 897-8491
Other providers in Lowell, MI
- Paul R Gauthier
- Tegan Gaye
- Lydia Joan Gerard
- Amanda Germanese
- Heather Gietzen
- Nicole Lynn Gillikin
- Ann Goodfellow
- Ashley A Goodwin
- Heidi Marie Gordon
- Grand River Orthodontics, PC
All providers in Lowell, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.