Susan Lynn Micklow, DDS MS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

2901014731 Issued in MI

Practice address

2336 US Hwy 41 South
Marquette, MI 49855

Phone

(906) 225-4520

Fax

(906) 225-4522

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1902915192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2336 US HWY 41 SOUTH",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-4520",
            "fax_number": "906-225-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2336 US HWY 41 SOUTH",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-4520",
            "fax_number": "906-225-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLOW",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "2901014731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael G Lasich PLLC
• Michael K Conley M.D., P.C.
• Nathan D Michels, LPC
• Lauren Elizabeth Michie, LLMSW
• Michigan in-Home Partner-I, LLC (UP Health System Home Care and Hospice)
• Beryl Cailyn Miess
• Mansour Miky, M.D.
• Mark Campbell Miles, PT
• Milestones and Mobility Center, Inc.
• Cecily Milkie, LPN

• Endodontics in Marquette, MI
• Providers in Marquette, MI by specialty
• Endodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.