William Joseph Doherty, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901020982 Issued in MI

Practice address

3784 Dix Hwy
Lincoln Park, MI 48146-3881

Phone

(313) 388-2400

Fax

(313) 386-9550

NPI assigned

Jun 19, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• William J Doherty, DDS, PC

  • Dental Clinic/Center
  • Tecumseh, MI
  • NPI 1548800873
  Medicare reassignment NPD Authorized official
• Paul M Polyviou DDS, P.C.

  • General Practice Dentistry
  • Lincoln Park, MI
  • NPI 1538285150
  NPD (past)

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1801235270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3784 DIX TOLEDO RD.",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "48146",
            "telephone_number": "313-388-2400",
            "fax_number": "313-386-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3784 DIX HWY",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463881",
            "telephone_number": "313-388-2400",
            "fax_number": "313-386-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Health Group of Michgian
• Vincent Dicarlo
• Crystal Dickow
• Jeremy David Diehl, CHW
• Michael R Dillard
• Stephanie Lee Dorris
• Downriver Dental Associates P.C.
• Downriver Drugs
• Downriver Family Physicians PC
• Downriver Wellness Group

• Dentist in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.