Individual provider Active NPI

Christina M Bacho, D.D.S.

  • Dentist
  • Clinton Township, MI
National Provider Identifier
1790193217
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021242 Issued in MI
Practice address
43900 Garfield Rd Ste 229
Clinton Township, MI 48038-1137
Phone
(586) 263-1010
NPI assigned
Jul 28, 2014
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021242 MI Primary

Addresses

Primary practice location

43900 Garfield Rd Ste 229
Clinton Township, MI 48038-1137

Mailing address

43900 Garfield Rd Ste 229
Clinton Township, MI 48038-1137
Phone (586) 263-1010

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
I20150901003083 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4082920392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
H2G Dental PLLC CurrentSince Mar 24, 2024 Accepting new patients

Locations

43900 Garfield Rd
Ste 229
Clinton Twp, MI 48038
Phone (586) 263-1010

Organizations & group practices 1

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": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1790193217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD STE 229",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381137",
            "telephone_number": "586-263-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD STE 229",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381137",
            "telephone_number": "586-263-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHO",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.