Active NPI
Nicholas Andre Fontana, D.D.S.
- General Practice Dentistry
- Troy, MI
National Provider Identifier
1891818191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10219
- Practice address
- 2877 Crooks Rd
Suite a
Troy, MI 48084-4717 - Phone
- (248) 650-6126
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10219 | MI | Primary |
Addresses
Primary practice location
2877 Crooks Rd
Suite a
Troy, MI 48084-4717
Mailing address
2599 Summerlin CT
Suite a
Rochester, MI 48306-2290
Phone (248) 650-6126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10219 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389657600000",
"number": "1891818191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2599 SUMMERLIN CT",
"address_2": "SUITE A",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "483062290",
"telephone_number": "248-650-6126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2877 CROOKS RD",
"address_2": "SUITE A",
"city": "TROY",
"state": "MI",
"postal_code": "480844717",
"telephone_number": "248-650-6126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONTANA",
"first_name": "NICHOLAS",
"middle_name": "ANDRE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2014-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "10219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.