Regents of the University of Michigan Dental Faculty Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901016040 Issued in MI

Legal business name

REGENTS OF THE UNIVERSITY OF MICHIGAN DENTAL FACULTY ASSOCIATES

Practice address

1011 N University Ave
Ann Arbor, MI 48109-1078

Phone

(734) 764-3155

Fax

(734) 615-4784

NPI assigned

Nov 8, 2006

Last updated

Aug 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter J Polverini, DDSNPI 1699808857

Title

Dean, Univ of Mi School of Dentistr

Phone

(734) 764-9185

Specialties & licenses 10

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Tax ID family

Regents of the University of Michigan Dental Faculty Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Regents of the University of Michigan Dental Faculty Associates

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1386899805
  NPD tax ID
• Regents of the University of Michigan Dental Faculty Associates

  dba Dental Faculty Associates

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Ann Arbor, MI
  • NPI 1528370434
  NPD tax ID

Locations

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theodora E Danciu, DMD, DMSC

  • Oral and Maxillofacial Pathology Dentistry
  • Ann Arbor, MI
  • NPI 1184861080
  Medicare reassignment Care Compare group NPD
• Sean Peter Edwards, MD, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Ann Arbor, MI
  • NPI 1952313892
  Medicare reassignment Care Compare group NPD
• Felipe Nor, DDS, MS, PHD

  • Oral and Maxillofacial Pathology Dentistry
  • Ann Arbor, MI
  • NPI 1083385629
  Medicare reassignment Care Compare group NPD
• Berna Saglik, D.D.S.

  • Prosthodontics
  • Ann Arbor, MI
  • NPI 1477745057
  Medicare reassignment Care Compare group NPD
• Stephanie Marie Munz, DDS

  • Dentist
  • Ann Arbor, MI
  • NPI 1104119114
  Medicare reassignment Care Compare group
• Sharon Aronovich, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Ann Arbor, MI
  • NPI 1871777326
  Medicare reassignment NPD
• Sun-Yung Bak, D.D.S.

  • Prosthodontics
  • Ann Arbor, MI
  • NPI 1255343075

  Dentist

  Medicare reassignment NPD
• Amy Man-Wai Chin, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Ann Arbor, MI
  • NPI 1114144581

  General Practice

  Medicare reassignment NPD
• Ann Marie Decker, DMD

  • Dentist
  • Ann Arbor, MI
  • NPI 1053768978
  Medicare reassignment NPD
• Elliott E Hill, DDS

  • General Practice Dentistry
  • Ann Arbor, MI
  • NPI 1033366430
  Medicare reassignment NPD
• Purnima Kumar, DDS, PHD

  • Dentist
  • Ann Arbor, MI
  • NPI 1548318652
  Medicare reassignment NPD
• Hsiao Hsin Sung Hsieh, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Ann Arbor, MI
  • NPI 1205191590

  General Practice

  Medicare reassignment NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1932279882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-764-9185",
            "fax_number": "734-647-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-764-3155",
            "fax_number": "734-615-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN DENTAL FACULTY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "POLVERINI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DEAN, UNIV OF MI SCHOOL OF DENTISTR",
        "authorized_official_telephone_number": "734-764-9185",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016040",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI MEDSURG #",
            "identifier": "190H110980",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4504346",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2667609",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF MI - GENL",
            "identifier": "88054",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN ADVANTAGE",
            "identifier": "1006664",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH",
            "identifier": "025748",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1476671",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI GENLDENTIST",
            "identifier": "D800363",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI ORALSURGERY",
            "identifier": "970H110770",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS OF MI",
            "identifier": "XX19411",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4504373",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP OF MI",
            "identifier": "43-20001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP OF MI",
            "identifier": "43-28004",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA HEALTHCARE",
            "identifier": "QMXPR0014549",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regents of the University of Michigan Ambulatory Pharmacy
• Regents of the University of Michigan Ambulatory Pharmacy
• Regents of the University of Michigan Center for the Child and Family
• Regents of the University of Michigan Dental Faculty Associates
• Regents of the University of Michigan Dental Faculty Associates (Dental Faculty Associates)
• Regents of the University of Michigan Mworks
• Regents of the University of Michigan Oral Pathology
• Regents of the University of Michigan Oral Pathology
• Regents of the University of Michigan Pediatric Surgery Offsite
• Regents of the University of Michigan School of Dentistry

• General Practice Dentistry in Ann Arbor, MI
• Providers in Ann Arbor, 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 Aug 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.