Individual provider Active NPI

John Metodi Pogoncheff, DDS

  • Dentist
  • Lansing, MI
National Provider Identifier
1821381989
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020411 Issued in MI
Practice address
2628 Lake Lansing Rd Ste 101
Lansing, MI 48912-3668
Phone
(517) 482-5636
Fax
(517) 482-5637
NPI assigned
May 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020411 MI Primary

Addresses

Primary practice location

2628 Lake Lansing Rd Ste 101
Lansing, MI 48912-3668

Mailing address

2628 Lake Lansing Rd Ste 101
Lansing, MI 48912-3668
Phone (517) 482-5636

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
I20161012002082 MI Order and Referring Only - DentistPractitioner - Dentist 0941598635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Metodi C Pogoncheff DDS PC Past 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": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1821381989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2628 LAKE LANSING RD STE 101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123668",
            "telephone_number": "517-482-5636",
            "fax_number": "517-482-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 LAKE LANSING RD STE 101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123668",
            "telephone_number": "517-482-5636",
            "fax_number": "517-482-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGONCHEFF",
        "first_name": "JOHN",
        "middle_name": "METODI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-24",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.