Individual provider Active NPI

Joel Elliot Griffin, DDS

  • Dentist
  • Pontiac, MI
National Provider Identifier
1902420185
Registry record updated Jun 3, 2020
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2951000816 Issued in MI
Practice address
44405 Woodward Ave # H23
Pontiac, MI 48341-5023
Phone
(269) 873-7033
NPI assigned
Jun 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2951000816 MI Primary

Addresses

Primary practice location

44405 Woodward Ave # H23
Pontiac, MI 48341-5023

Mailing address

44405 Woodward Ave # H23
Pontiac, MI 48341-5023
Phone (269) 873-7033

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
I20200805003103 MI Order and Referring Only - DentistPractitioner - Dentist 3971928003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1902420185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE # H23",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "269-873-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE # H23",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "269-873-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "JOEL",
        "middle_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2951000816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.