Individual provider Active NPI

Nicholas Gerard Schesnuk, D.D.S.

  • General Practice Dentistry
  • Chesterfield, MI
National Provider Identifier
1861842189
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901021946 Issued in MI
Practice address
31290 23 Mile Rd
Chesterfield, MI 48047-1850
Phone
(586) 949-0611
Fax
(586) 949-1714
NPI assigned
Jun 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901021946 MI Primary

Addresses

Primary practice location

31290 23 Mile Rd
Chesterfield, MI 48047-1850

Mailing address

31290 23 Mile Rd
Chesterfield, MI 48047-1850
Phone (586) 949-0611

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
I20160812001168 MI Order and Referring Only - DentistPractitioner - Dentist 1557655669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021946MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Peter Michael Carlin General Practice 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": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1861842189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31290 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480471850",
            "telephone_number": "586-949-0611",
            "fax_number": "586-949-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31290 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480471850",
            "telephone_number": "586-949-0611",
            "fax_number": "586-949-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHESNUK",
        "first_name": "NICHOLAS",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

Verify at the official NPI Registry.