Individual provider Active NPI

Jeffrey Mark Helmus, D.D.S

  • General Practice Dentistry
  • Wyoming, MI
National Provider Identifier
1992718167
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018838 Issued in MI
Practice address
2663 44TH St SW
Suite 204
Wyoming, MI 49519-4189
Phone
(616) 538-7320
Fax
(616) 538-7666
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 2901018838 MI Primary

Addresses

Primary practice location

2663 44TH St SW
Suite 204
Wyoming, MI 49519-4189

Mailing address

2663 44TH St SW
Suite 204
Wyoming, MI 49519-4189
Phone (616) 538-7320

Other identifiers 2

IdentifierTypeStateIssuer
4633989MedicaidMI
D188380OtherMIBCBS

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
I20160509002330 MI Order and Referring Only - DentistPractitioner - Dentist 6002115391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
River Ridge Dentistry CurrentSince Jan 24, 2021 Accepting new patients

Locations

5675 Burlingame Ave SW
Ste C
Wyoming, MI 49509
Phone (616) 538-7320

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992718167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2663 44TH ST SW",
            "address_2": "SUITE 204",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194189",
            "telephone_number": "616-538-7320",
            "fax_number": "616-538-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2663 44TH ST SW",
            "address_2": "SUITE 204",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194189",
            "telephone_number": "616-538-7320",
            "fax_number": "616-538-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELMUS",
        "first_name": "JEFFREY",
        "middle_name": "MARK",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4633989",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "D188380",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.