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NPI 1063240851ActiveIndividual· Dentist· Flint, MI

Dentist in Flint, Michigan, licensed in MI, with an NPI issued in July 2024. Part D covered 33 prescriptions written in 2024, 91% of them generic.

Overview

NPI1063240851
StatusActive
Entity typeIndividual
Sole proprietorYes
NPI issuedJul 23, 2024
Last updated in NPPESJul 23, 2024
Certified by providerMar 8, 2024

Specialties and licenses

TaxonomyCodeLicenseState
Dentist Primary122300000X2901602048MI

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Part D prescriptions in 2024

Prescriptions (claims)33 · 33 30-day fills
Patients23
Total drug cost$128.76
Generic share91% of claims

Medicare sources and data years

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other Dentist providers in Flint

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