Individual provider Active NPI

Rena Allswang, DDS

  • Dentist
  • Taylor, MI
National Provider Identifier
1831403856
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020278 Issued in MI
Practice address
20302 Eureka Rd
Suite a
Taylor, MI 48180-5310
Phone
(734) 283-5757
NPI assigned
Aug 2, 2010
Last updated
Sep 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020278 MI Primary

Addresses

Primary practice location

20302 Eureka Rd
Suite a
Taylor, MI 48180-5310

Mailing address

25560 Woodvilla PL
Southfield, MI 48075-2047
Phone (347) 665-3464

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
I20170405000093 MI Order and Referring Only - DentistPractitioner - Dentist 8921384090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020278MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Oakcrest Dental Center, PC Past Accepting new patients
Dearborn Family Dentistry PC Dentist PastSince Oct 1, 2016 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1831403856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25560 WOODVILLA PL",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752047",
            "telephone_number": "347-665-3464",
            "fax_number": "347-665-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20302 EUREKA RD",
            "address_2": "SUITE A",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481805310",
            "telephone_number": "734-283-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLSWANG",
        "first_name": "RENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-02",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.