Individual provider Active NPI

Michael S Wojcik, DDS,MS

  • Periodontics
  • Sterling Heights, MI
National Provider Identifier
1861402356
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2901015079 Issued in MI
Practice address
8130 Constitution Blvd
Sterling Heights, MI 48313-3801
Phone
(586) 268-5520
Fax
(586) 268-1288
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

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
Periodontics 1223P0300X 2901015079 MI Primary

Addresses

Primary practice location

8130 Constitution Blvd
Sterling Heights, MI 48313-3801

Mailing address

8130 Constitution Blvd
Sterling Heights, MI 48313-3801
Phone (586) 268-5520

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
I20170424000400 MI Order and Referring Only - DentistPractitioner - Dentist 9638273592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861402356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8130 CONSTITUTION BLVD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483133801",
            "telephone_number": "586-268-5520",
            "fax_number": "586-268-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 CONSTITUTION BLVD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483133801",
            "telephone_number": "586-268-5520",
            "fax_number": "586-268-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJCIK",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901015079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.