Individual provider Active NPI

Marc Stuart Globerman, D.D.S.

  • Dentist
  • W Bloomfield, MI
National Provider Identifier
1962557397
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12489 Issued in MI
Practice address
7439 Middlebelt Rd
W Bloomfield, MI 48322-4183
Phone
(248) 626-3701
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12489 MI Primary

Addresses

Primary practice location

7439 Middlebelt Rd
W Bloomfield, MI 48322-4183

Mailing address

29990 Kingsway Dr
Farmington Hills, MI 48331-1707
Phone (248) 661-2053

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
I20150515000359 MI Order and Referring Only - DentistPractitioner - Dentist 4082934047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12489MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962557397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29990 KINGSWAY DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483311707",
            "telephone_number": "248-661-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7439 MIDDLEBELT RD",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224183",
            "telephone_number": "248-626-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOBERMAN",
        "first_name": "MARC",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "12489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.