Individual provider Active NPI

Herschel Simeon Ungar, DDS

  • Dentist
  • Farmington Hills, MI
National Provider Identifier
1821616871
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901600610 Issued in MI
Practice address
29224 W 8 Mile Rd
Farmington Hills, MI 48336-5500
Phone
(248) 478-1650
NPI assigned
Jul 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901600610 MI Primary

Addresses

Primary practice location

29224 W 8 Mile Rd
Farmington Hills, MI 48336-5500

Mailing address

26261 Raine St
Oak Park, MI 48237-1059

Other practice location 1

26261 Raine St
Oak Park, MI 48237-1059
Phone (248) 935-7188

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL pesisd@gmail.com

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
I20200806000346 MI Order and Referring Only - DentistPractitioner - Dentist 0446675599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901600610MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pesis Dental Group, P.C. PastSince Jul 12, 2020 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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1821616871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26261 RAINE ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29224 W 8 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365500",
            "telephone_number": "248-478-1650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26261 Raine St",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "MI",
            "postal_code": "482371059",
            "country_code": "US",
            "telephone_number": "248-935-7188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNGAR",
        "first_name": "HERSCHEL",
        "middle_name": "SIMEON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pesisd@gmail.com",
            "affiliation": "N",
            "address_1": "29224 W 8 Mile Rd",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483365500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.