DR. KERRI SUE GUSTAFSON (NPI# 1316910763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316910763 |
Entity Type | Individual |
Full Name | DR. KERRI SUE GUSTAFSON |
Credential | DDS |
Practice Address |
18245 E 10 Mile Rd Suite 110 Roseville MI 48066-5807 |
Practice Telephone | 5865852402 |
Practice Fax Number | 5864451473 |
Mailing Telephone | (586) 585-2402 |
Mailing Fax Number | 5864451473 |
Enumeration Date | 2006-02-08 |
Last Update Date | 2017-07-12 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2901018319 | MI | Dental Providers |
Street Address |
18245 E 10 MILE RD SUITE 110 |
City | ROSEVILLE |
State | MI |
Zip Code | 48066-5807 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609868496 | Jeffrey Maurice Hall | Surgery | 18245 E 10 Mile Rd, Suite 130, Roseville, MI 48066-5807 | 2005-08-17 |
1215402078 | Mitchell Brian Schram | Occupational Therapist | 18245 E 10 Mile Rd, Roseville, MI 48066-5807 | 2018-10-09 |
1609216829 | Cube | Community/Behavioral Health | 18245 E 10 Mile Rd, Suite 140, Roseville, MI 48066-5807 | 2013-07-02 |
1740625508 | Mazin Mohi Deen | Internal Medicine | 18245 E 10 Mile Rd, Suite 120, Roseville, MI 48066-5807 | 2013-05-07 |
1356377501 | Dudley Roberts M.d, L.L.C. | Internal Medicine | 18245 E 10 Mile Rd, Suite 120, Roseville, MI 48066-5807 | 2006-06-22 |
1922094507 | Dudley Roberts IIi | Internal Medicine | 18245 E 10 Mile Rd, Roseville, MI 48066-5807 | 2005-09-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
Find all providers in zip 48066 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447884069 | Jocelyn M. Robelli Dds, Ms, Pllc | Dentist | 18245 E 10 Mile Rd Ste 110, Roseville, MI 48066-5807 | 2020-02-24 |
1205113859 | Richard Knight | Dentist | 2520 Douglas Blvd Ste 130, Roseville, CA 95661-3993 | 2011-11-10 |
1982890331 | Jack Lowell Moore | Dentist | 700 Sunrise Avenue, Suite C, Roseville, CA 95661-4561 | 2007-09-19 |
1780750539 | Dental Specialists of Minnesota, Pllc | Dentist | 1835 County Road C-west, Suite 200, Roseville, MN 55113-1343 | 2006-11-24 |
1366448524 | Linda Patricia Rafferty | Dentist | 2520 Douglas Blvd, Ste 130, Roseville, CA 95661-3993 | 2005-06-22 |
1295347805 | Kerri S. Gustafson, Dds, Pllc, Dentistry for Children | Dentist | 18245 E 10 Mile Rd Ste 110, Roseville, MI 48066-5807 | 2020-08-17 |
1033639463 | Crutchfield Pediatric Dental Group | Dentist | 1253 Pleasant Grove Blvd Ste 190, Roseville, CA 95678-6983 | 2017-06-27 |
1336696426 | Dmitriy Pivnik Dds Inc | Dentist | 721 Pleasant Grove Blvd Ste 150, Roseville, CA 95678-6181 | 2016-09-06 |
1275991721 | Dmitriy Pivnik | Dentist | 721 Pleasant Grove Blvd Ste 150, Roseville, CA 95678-6181 | 2016-01-29 |
1760710834 | Cassandra Krupansky | Dentist | 2520 Douglas Blvd, Suite 130, Roseville, CA 95661-3992 | 2009-11-30 |
Find all providers in ROSEVILLE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.