Individual provider Active NPI

Robert Leo Tremblay, D.D.S.

  • General Practice Dentistry
  • Huntington Woods, MI
National Provider Identifier
1801915756
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11458 Issued in MI
Practice address
26711 Woodward Ave Ste 105
Huntington Woods, MI 48070-1367
Phone
(248) 543-3834
Fax
(248) 543-5535
NPI assigned
Mar 29, 2007
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
General Practice Dentistry 1223G0001X 11458 MI Primary

Addresses

Primary practice location

26711 Woodward Ave Ste 105
Huntington Woods, MI 48070-1367

Mailing address

26711 Woodward Ave Ste 105
Huntington Woods, MI 48070-1367
Phone (248) 543-3834

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
I20160208002118 MI Order and Referring Only - DentistPractitioner - Dentist 5496059644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11458MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aimee B. Chisik DDS, P.C. General Practice PastSince Jan 29, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801915756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26711 WOODWARD AVE STE 105",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701367",
            "telephone_number": "248-543-3834",
            "fax_number": "248-543-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26711 WOODWARD AVE STE 105",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701367",
            "telephone_number": "248-543-3834",
            "fax_number": "248-543-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREMBLAY",
        "first_name": "ROBERT",
        "middle_name": "LEO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Woods, MI

Sources for this page

Verify at the official NPI Registry.