Mike Hewlett, DMD
Individual provider Active NPI Dentist · Cassopolis, MI
NPI 1891241196 · NPPES record last updated Oct 18, 2016
Key facts
- NPI
- 1891241196
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2901022012 (MI)
- Practice address
- 261 M-62
Cassopolis, MI 49031 - Phone
- (269) 445-3874
- NPI assigned
- Aug 28, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901022012 | MI | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901022012 | MI | Yes |
Addresses
Primary practice location
261 M-62
Cassopolis, MI 49031
Mailing address
122 Grant St
Niles, MI 49120-2281
Phone (269) 262-4364
Other providers in Cassopolis, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.