Individual provider Active NPI

Ghabi A. Kaspo, DDS

  • Orofacial Pain Dentistry
  • Royal Oak, MI
National Provider Identifier
1912923855
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
2901015677 Issued in MI
Practice address
110 E 2ND St
Royal Oak, MI 48067-2694
Phone
(800) 653-6568
Fax
(313) 876-1305
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0015677 MI
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2901015677 MI
Orofacial Pain Dentistry 1223X2210X 0015677 MI
Orofacial Pain Dentistry 1223X2210X 2901015677 MI Primary

Addresses

Primary practice location

110 E 2ND St
Royal Oak, MI 48067-2694

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 876-4806

Other practice location 1

3144 John R Rd Ste 100
Troy, MI 48083-5930
Phone (248) 519-1100

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
I20060223000295 MI Practitioner - Oral SurgeryPractitioner - Orofacial Pain 4981610425 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Orofacial Pain
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
Premier Therapy Centers, IncGroup PAC ID 5092605717, 140 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 876-2795

3144 John R Rd
Troy, MI 48083-5936
Phone (248) 519-1100

33010 Northwestern Hwy
West Bloomfield, MI 48322-3634

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0015677MIMDOrofacial Pain Dentist
2901015677MIMDOrofacial Pain Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Pathology Current Accepting new patients
Facial Pain and Sleep Center PLC Oral and Maxillofacial Surgery CurrentSince Mar 1, 2006 Accepting new patients
Henry Ford Health System Oral and Maxillofacial Surgery CurrentSince Apr 11, 2023 Accepting new patients
Henry Ford Health System CurrentSince Apr 11, 2023 Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

110 E 2nd St
Fl 4
Royal Oak, MI 48067

110 E 2nd St
Royal Oak, MI 48067
Phone (248) 546-2110

3144 John R Rd
Ste 100
Troy, MI 48083
Phone (248) 510-1100

Interoperability endpoints

  • Direct secure messaging: gkaspo241790@direct.hfhs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1912923855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-876-4806",
            "fax_number": "248-546-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 2ND ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672694",
            "telephone_number": "800-653-6568",
            "fax_number": "313-876-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3144 John R Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480835930",
            "country_code": "US",
            "telephone_number": "248-519-1100",
            "fax_number": "248-809-4075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASPO",
        "first_name": "GHABI",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "0015677",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901015677",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "MI",
            "license": "0015677",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "MI",
            "license": "2901015677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.