Michael Petrouneas, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016540 Issued in MI

Practice address

122 Cole Rd
Monroe, MI 48162-4104

Phone

(734) 242-3311

Fax

(734) 242-6482

NPI assigned

Dec 26, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael Petrouneas DDS PC

  • Dentist
  • Monroe, MI
  • NPI 1649712670
  NPD (past) Authorized official

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1922163385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 COLE RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624104",
            "telephone_number": "734-242-3311",
            "fax_number": "734-242-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 COLE RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624104",
            "telephone_number": "734-242-3311",
            "fax_number": "734-242-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROUNEAS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "016540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4163944",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander James Peterson, D.D.S.
• Autumn Peterson
• Carolyn S Peterson, MSW
• Courtney A Peterson, LLC
• Denise Lynn Petree
• Pharmacy Counter, LLC
• Nicole Philippon, NP
• Physicians Technology, LLC
• Prezley Pietszak
• Stephan L Pietszak, BA

• General Practice Dentistry in Monroe, MI
• Providers in Monroe, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.