Michael Patrick McNutt, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16532 Issued in MI

Practice address

1881 N Pontiac TRL
Suite a
Walled Lake, MI 48390-3101

Phone

(248) 624-5996

Fax

(248) 624-5997

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Michael P McNutt D.D.S., P.C.

  • General Practice Dentistry
  • Walled Lake, MI
  • NPI 1669648945
  NPD (past) Authorized official

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821210568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 N PONTIAC TRL",
            "address_2": "SUITE A",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903101",
            "telephone_number": "248-624-5996",
            "fax_number": "248-624-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 N PONTIAC TRL",
            "address_2": "SUITE A",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903101",
            "telephone_number": "248-624-5996",
            "fax_number": "248-624-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNUTT",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kathryn Martin, NP
• Lisa Ann Martin
• David Hugh McAree, MD
• Kari McAvoy, N.P.
• McMaster Residential Homes, Inc
• Med Rent Inc
• Hanan Mehdi
• Merger Rehab Case Management
• Abigail Louise Mermuys
• Megan Metcalf, OTR/L

• General Practice Dentistry in Walled Lake, MI
• Providers in Walled Lake, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.