Benjamin Thomas Gietzen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022249 Issued in MI

Practice address

51333 Mound Rd
Shelby TWP, MI 48316-4344

Phone

(586) 799-4240

NPI assigned

Jun 18, 2017

Last updated

Jun 18, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497744000000",
    "number": "1922538370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 LINWOOD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480732353",
            "telephone_number": "616-490-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51333 MOUND RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483164344",
            "telephone_number": "586-799-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIETZEN",
        "first_name": "BENJAMIN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Caleb Gibson
• Marcella Ann Gibson
• Rebecca Gibson, DPT
• Gigante Chiropractic PLLC
• Wayne Luke Gigante, DC
• Lydia Gillim
• Anthony Ross Giordano, DPM
• Mark Gjokaj, DDS

• General Practice Dentistry in Shelby TWP, MI
• Providers in Shelby TWP, 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 Jun 18, 2017; 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.