Gary Allen Schluckebier, DDS
Individual provider Active NPI General Practice Dentistry · Ithaca, MI
NPI 1891831475 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1891831475
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2901016837 (MI)
- Practice address
- 921 N Pine River St
Ithaca, MI 48847-1119 - Phone
- (989) 875-4721
- Fax
- (989) 875-6018
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Dentist
- Education
- Indiana University School of Dentistry, 1995
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
501 Lapeer Ave
Saginaw, MI 48607-1203
501 Lapeer Ave
Saginaw, MI 48607-1255
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260519000204 | MI | Practitioner - Dentist | 7416212485 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horvat Family Dental Care, PLLC | Past |
Accepting new patients | |
| Gary a. Schluckebier, DDS, PLLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901016837 | MI | Yes |
Addresses
Primary practice location
921 N Pine River St
Ithaca, MI 48847-1119
Mailing address
921 N Pine River St
Ithaca, MI 48847-1119
Phone (989) 875-4721
Other providers in Ithaca, MI
- Putman Dental PLLC
- Brian Joseph Putman
- Jenna Putman
- Rite Aid of Michigan Inc
- Rosewood I & Rosewood II
- Hillary Agnes Shemes
- Megan Rose Silvers
- Leslie Skiera
- Smile Ithaca PLLC
- Shanna Smith
All providers in Ithaca, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.