Individual provider Active NPI

J. Michael Owen, DDS

  • General Practice Dentistry
  • Bingham Farms, MI
National Provider Identifier
1902964778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
MI-14273 Issued in MI
Practice address
31000 Telegraph Rd
#170
Bingham Farms, MI 48025-4360
Phone
(248) 646-8651
NPI assigned
Dec 5, 2006
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 MI-14273 MI Primary

Addresses

Primary practice location

31000 Telegraph Rd
#170
Bingham Farms, MI 48025-4360

Mailing address

31000 Telegraph Rd
#170
Bingham Farms, MI 48025-4360
Phone (248) 646-8651

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
I20181221002481 MI Order and Referring Only - DentistPractitioner - Dentist 2466797212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI-14273MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902964778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD",
            "address_2": "#170",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254360",
            "telephone_number": "248-646-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31000 TELEGRAPH RD",
            "address_2": "#170",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254360",
            "telephone_number": "248-646-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "J.",
        "middle_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "MI-14273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

Verify at the official NPI Registry.