Individual provider Active NPI

Morris Vincent Velilla, D.D.S.

  • General Practice Dentistry
  • Novi, MI
National Provider Identifier
1902934524
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16151 Issued in MI
Practice address
39915 Grand River Ave
Suite 500
Novi, MI 48375-2153
Phone
(248) 427-9003
Fax
(248) 427-9007
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 16151 MI Primary

Addresses

Primary practice location

39915 Grand River Ave
Suite 500
Novi, MI 48375-2153

Mailing address

39915 Grand River Ave
Suite 500
Novi, MI 48375-2153
Phone (248) 427-9003

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
I20160408000089 MI Order and Referring Only - DentistPractitioner - Dentist 8527366590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16151MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shah & Velilla DDS PC General Practice Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mvelilla2@direct.dmc.org

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902934524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39915 GRAND RIVER AVE",
            "address_2": "SUITE 500",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752153",
            "telephone_number": "248-427-9003",
            "fax_number": "248-427-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39915 GRAND RIVER AVE",
            "address_2": "SUITE 500",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752153",
            "telephone_number": "248-427-9003",
            "fax_number": "248-427-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELILLA",
        "first_name": "MORRIS",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.