Individual provider Active NPI

Robert G Trecapelli, D.D.S.

  • General Practice Dentistry
  • Shelby Township, MI
National Provider Identifier
1891175402
Registry record updated Mar 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901021510 Issued in MI
Practice address
51772 Van Dyke Ave
Shelby Township, MI 48316
Phone
(586) 233-3184
NPI assigned
Jun 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2019

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 2901021510 MI Primary

Addresses

Primary practice location

51772 Van Dyke Ave
Shelby Township, MI 48316

Mailing address

60244 Stonecrest Dr
Washington, MI 48094-1489
Phone (586) 233-3184

Other practice location 1

2501 W Pierson Rd
Flint, MI 48504-6802
Phone (810) 789-5880

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
I20160511000842 MI Order and Referring Only - DentistPractitioner - Dentist 8820387012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901021510MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Dreams, PLLC 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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551571200000",
    "number": "1891175402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60244 STONECREST DR",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480941489",
            "telephone_number": "586-233-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51772 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48316",
            "telephone_number": "586-233-3184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 W Pierson Rd",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485046802",
            "country_code": "US",
            "telephone_number": "810-789-5880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRECAPELLI",
        "first_name": "ROBERT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2019-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.