Marcos Massao Ioshida

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901602352 Issued in MI

Practice address

75 Scio Church Rd
Ann Arbor, MI 48103-6119

Phone

(734) 668-9988

NPI assigned

Sep 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Donald a. Wennersten D.D.S., P.C.

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1578781464
  NPD (past)

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1881363430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2264 FORTUNA WAY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082853",
            "telephone_number": "734-604-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SCIO CHURCH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036119",
            "telephone_number": "734-668-9988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482082576",
            "country_code": "US",
            "telephone_number": "313-494-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IOSHIDA",
        "first_name": "MARCOS",
        "middle_name": "MASSAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2952000768",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rachel Marie Iott, OTR
• Ka I Ip

• General Practice Dentistry in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.