Individual provider Active NPI

Bernadette Olameitan Osowa, DDS

  • General Practice Dentistry
  • New Baltimore, MI
National Provider Identifier
1942379631
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017947 Issued in MI
Practice address
35409 23 Mile Rd
New Baltimore, MI 48047-3601
Phone
(586) 725-9330
Fax
(586) 725-9330
NPI assigned
Nov 7, 2006
Last updated
Aug 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901017947 MI Primary

Addresses

Primary practice location

35409 23 Mile Rd
New Baltimore, MI 48047-3601

Mailing address

44892 Rivergate Drive
Clinton Township, MI 48038
Phone (586) 822-6302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901017947MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Osowa Dental, PLLC General Practice CurrentSince Jul 1, 2023 Accepting new patients
Dr. Leigh Ellen Snyder DDS General Practice PastSince Sep 13, 2020 Accepting new patients

Locations

35409 23 Mile Rd
New Baltimore, MI 48047
Phone (586) 725-9330

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1942379631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44892 RIVERGATE DRIVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "48038",
            "telephone_number": "586-822-6302",
            "fax_number": "586-775-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35409 23 MILE RD",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480473601",
            "telephone_number": "586-725-9330",
            "fax_number": "586-725-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSOWA",
        "first_name": "BERNADETTE",
        "middle_name": "OLAMEITAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Baltimore, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.