Individual provider Active NPI

Jeffrey Selasky, DDS

  • General Practice Dentistry
  • Livonia, MI
National Provider Identifier
1902285521
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901021516 Issued in MI
Practice address
38000 Ann Arbor TRL
Livonia, MI 48150-2453
Phone
(734) 591-3636
Fax
(734) 591-3355
NPI assigned
May 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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 2901021516 MI Primary

Addresses

Primary practice location

38000 Ann Arbor TRL
Livonia, MI 48150-2453

Mailing address

38000 Ann Arbor TRL
Livonia, MI 48150-2453
Phone (734) 591-3636

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Dental Group 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": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1902285521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38000 ANN ARBOR TRL",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502453",
            "telephone_number": "734-591-3636",
            "fax_number": "734-591-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38000 ANN ARBOR TRL",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502453",
            "telephone_number": "734-591-3636",
            "fax_number": "734-591-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELASKY",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-28",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.