Suzanne Amanda Fisher, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022300 Issued in MI

Practice address

25660 Pontiac TRL
South Lyon, MI 48178-8046

Phone

(248) 446-2700

NPI assigned

Jul 22, 2009

Last updated

Nov 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Michelle R Conforti

  dba Gateway Dental Care

  • Dentist
  • South Lyon, MI
  • NPI 1053922468
  NPD
• Gateway Dental Care, PLC

  dba Gateway Dental Care

  • Dentist
  • South Lyon, MI
  • NPI 1265984041
  NPD (past)

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1972733038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 ANDOVER ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25660 PONTIAC TRL",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481788046",
            "telephone_number": "248-446-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "SUZANNE",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022300",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Wellness Counseling PLLC
• Mohamed Ali Faraj, PHARMD
• Erica Farnick, AGACNP-BC
• Carsten Fiedler, LMT
• Alexander Field, OTRL
• Sarah Marie Flores
• Deborah J Ford-Ditto, MA, LPC, CRC
• Greysen Andrew Foss, DO
• Kelly Frakes, LLPC
• Michelle Fras, M.A. CCC-SLP

• General Practice Dentistry in South Lyon, MI
• Providers in South Lyon, 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 Nov 19, 2021; 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.