Individual provider Active NPI

Meghan Brodsky, D.D.S.

  • General Practice Dentistry
  • Warren, MI
National Provider Identifier
1922453539
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16367 Issued in MD
Practice address
12500 E 12 Mile Rd
Warren, MI 48093
Phone
(586) 573-6677
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 16367 MD Primary

Addresses

Primary practice location

12500 E 12 Mile Rd
Warren, MI 48093

Mailing address

9915 Pine Valley TRL
Brighton, MI 48114-8964
Phone (810) 962-0084

Other practice location 1

1001 S George St
York Hospital
York, PA 17403-3676
Phone (717) 851-2655

Other practice location 2

603 Nursery Rd
Westminster, MD 21157-6109
Phone (410) 848-5577

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
I20180905000337 MI Order and Referring Only - DentistPractitioner - Dentist 6901156439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16367MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll County Dental Associates, LLC General Practice Past Accepting new patients
Dental Associates L.L.C. General Practice Past Accepting new patients
Barry S. Pinsky DDS, & Ellen B. Folbe DDS, PC General Practice Past Accepting new patients

Organizations & group practices 3

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1922453539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9915 PINE VALLEY TRL",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481148964",
            "telephone_number": "810-962-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-6677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S George St",
            "address_2": "York Hospital",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174033676",
            "country_code": "US",
            "telephone_number": "717-851-2655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 Nursery Rd",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211576109",
            "country_code": "US",
            "telephone_number": "410-848-5577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODSKY",
        "first_name": "MEGHAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.