DR. MICHAEL FOSSELMAN (NPI# 1366514895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366514895 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL FOSSELMAN |
| Credential | D.D.S.,M.S. |
| Practice Address |
106 S Cummings Ln Washington IL 61571-3442 |
| Practice Telephone | 3094449777 |
| Mailing Telephone | 3094449777 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
IL | Dental Providers |
| Street Address |
106 S CUMMINGS LN |
| City | WASHINGTON |
| State | IL |
| Zip Code | 61571-3442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093709842 | Lee Eugene Moore | Dentist | 106 S Cummings Ln, Washington, IL 61571-3442 | 2005-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904504 | Kelly Hornberger | Physical Therapist | 1201 Newcastle Rd., Washington, IL 61571 | 2018-09-01 |
| 1073050407 | Jillyn Cross | Occupational Therapist | 14 Oxford Court, Washington, IL 61571 | 2017-01-24 |
| 1639410772 | Stephen L Dejaynes | Counselor | 100 Hillcrest Drive, Washington, IL 61571 | 2013-03-14 |
| 1184998692 | One Counseling and Wellness | Counselor | 1003 North Cummings Lane, Washington, IL 61571 | 2012-03-01 |
| 1871878371 | M Lisa Kim | Pharmacist | 1700 Saddleridge Ct, Washington, IL 61571 | 2011-10-15 |
| 1073805156 | Skill Sprout International | Behavioral Analyst | 102 Walnut Street, Washington, IL 61571 | 2011-05-09 |
| 1659600948 | Skill Sprout, LLC | Behavioral Analyst | 128 Washington Square, Washington, IL 61571 | 2009-12-15 |
| 1700024916 | Julie Adams | Developmental Therapist | 700 S. Elm, Washington, IL 61571 | 2009-01-26 |
| 1851595128 | Michael John Herman | Dentist | 106 So Cummings Lane, Washington, IL 61571 | 2007-06-12 |
| 1861539132 | Gary Lee Cunningham | Dentist | 5 Laurel Ct., Washington, IL 61571 | 2007-01-30 |
| Find all providers in zip 61571 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083214829 | Evenly Dc, Pllc | Dentist | 1619 Connecticut Ave Nw, Washington, DC 20009-1013 | 2020-10-30 |
| 1821605932 | Candid Washington D.c., Pllc | Dentist | 700 5th St Nw Fl 2, Washington, DC 20001-2752 | 2020-09-23 |
| 1306472675 | Cintia Helena Zingaretti Junqueira Mendes | Dentist | 110 Irving St Nw Ste Ga141d, Washington, DC 20010-3017 | 2020-03-19 |
| 1376178194 | Infinity Orthodontics P.C. | Dentist | 1147 20th St Nw Ste 200, Washington, DC 20036-3573 | 2020-03-12 |
| 1235786328 | Washington Airway & Wellness Center, LLC | Dentist | 1625 K St Nw Frnt 1, Washington, DC 20006-1610 | 2019-08-22 |
| 1366095440 | John Shefferman | Dentist | 1747 Pennsylvania Ave Nw Ste 120, Washington, DC 20006-4604 | 2019-07-18 |
| 1417511627 | Tusk Orthodontics Pllc | Dentist | 3900 Kansas Ave Nw Ste 101, Washington, DC 20011-5712 | 2019-04-24 |
| 1598265944 | Family Orthodontics of Dc Pllc | Dentist | 5301 Wisconsin Ave Nw Ste 200, Washington, DC 20015 | 2018-02-12 |
| 1013467588 | Kathryn Jan Clark | Dentist | 4110 River Rd Nw, Washington, DC 20016-4618 | 2016-10-10 |
| 1528412426 | Hamid Reza Saranjam | Dentist | 818 18th St Nw Ste 747, Washington, DC 20006-3513 | 2016-04-17 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 61571 |
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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.