Individual provider Active NPI

Austin John Asoklis, DDS

  • General Practice Dentistry
  • Fort Gratiot, MI
National Provider Identifier
1982213641
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901600889 Issued in MI
Practice address
4216 24TH Ave Ste 100
Fort Gratiot, MI 48059-3880
Phone
(810) 984-8669
NPI assigned
Jul 29, 2020
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D010778 AZ
General Practice Dentistry 1223G0001X 2901600889 MI Primary

Addresses

Primary practice location

4216 24TH Ave Ste 100
Fort Gratiot, MI 48059-3880

Mailing address

47351 Bobwhite LN
Shelby TWP, MI 48315-4825
Phone (586) 747-6291

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
D010778AZMDGeneral Practice Dentistry
2901600889MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DS Dental Group PLLC General Practice CurrentSince Aug 1, 2020 Accepting new patients
Brandon D Arnow DMD PLC General Practice PastSince Aug 1, 2020 Accepting new patients
Scott Nigl Dental PC General Practice PastSince Jun 6, 2021 Accepting new patients

Locations

1155 S Power Rd
Ste 112B
Mesa, AZ 85206
Phone (480) 733-0077

Organizations & group practices 3

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": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1982213641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47351 BOBWHITE LN",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483154825",
            "telephone_number": "586-747-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 24TH AVE STE 100",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593880",
            "telephone_number": "810-984-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASOKLIS",
        "first_name": "AUSTIN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010778",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.