DR. ANGELA DENA ICEBERG (NPI# 1598787749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598787749 |
| Entity Type | Individual |
| Full Name | DR. ANGELA DENA ICEBERG |
| Credential | O.D. |
| Practice Address |
31815 Southfield Rd Ste 12 Beverly Hills MI 48025 |
| Mailing Address |
227 Corey Ln Ortonville MI 48462-9707 |
| Practice Telephone | 2486452220 |
| Practice Fax Number | 8775478277 |
| Mailing Telephone | 2488844246 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2018-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 5330000481 | MI | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE PTAN | MI1300001 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 31815 Southfield Rd, Suite 12, Beverly Hills, MI 480255471 | 2486452220 |
| Street Address |
31815 SOUTHFIELD RD STE 12 |
| City | BEVERLY HILLS |
| State | MI |
| Zip Code | 48025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174518435 | Sheldon D Stern | Ophthalmology | 31815 Southfield Rd Ste 12, Beverly Hills, MI 48025-5471 | 2005-09-13 |
| 1538775051 | Hills Eyecare and Optical Plc | Optometrist | 31815 Southfield Rd Ste 12, Beverly Hills, MI 48025-5471 | 2020-09-21 |
| 1437204815 | Amy Crissman Head | Optometrist | 31815 Southfield Rd Ste 12, Beverly Hills, MI 48025-5471 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518571413 | Cole Nicolas Gomez | Technician/Technologist | 32199 Telegraph Rd, Bingham Farms, MI 48025 | 2020-09-08 |
| 1346859212 | Jordyn Jones | Technician/Technologist | 32199 Telegraph Rd Ste 205, Bingham Farms, MI 48025 | 2020-07-27 |
| 1013492644 | Shaniya Hyman | Technician/Technologist | 32100 Telegraph Rd Suit 205, Bingham Farms, MI 48025 | 2018-09-28 |
| 1043799042 | Assisted Home Health | Hospice Care, Community Based | 20150 Plantation Ln, Beverly Hills, MI 48025 | 2018-08-09 |
| 1235618224 | Robert Dean Harley | Technician/Technologist | 31200 Telegraph Rd Ste 205, Bingham Farms, MI 48025 | 2018-08-09 |
| 1760973911 | Tailormed Medical Inc | Case Management | 30100 Telegraph Road, Suite 403, Bringham Farms, MI 48025 | 2018-05-23 |
| 1245745447 | Supportive Home Health Care LLC | Home Health | 30100 Telegraph Rd Ste 478, Bingham Farms, MI 48025 | 2017-12-11 |
| 1265954192 | Breeona Rue | Technician/Technologist | 32100 Telegraph Rd Suite 205, Bingham Farms, MI 48025 | 2017-07-12 |
| 1417478132 | Gina Maria Bignotti | Behavior Technician | 32100 Telegraph, Bingham Farms, MI 48025 | 2017-07-03 |
| 1295256238 | Chanel Matti | Behavior Technician | 32100 Telegraph Rd Suite 185, Bingham Farms, MI 48025 | 2017-06-29 |
| Find all providers in zip 48025 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922569938 | Gregory Yamaguchi | Optometrist | 250 N Robertson Blvd Ste 102, Beverly Hills, CA 90211-1767 | 2019-03-31 |
| 1538689112 | Ashley M Deese | Optometrist | 450 N Bedford Dr Ste 101, Beverly Hills, CA 90210-4305 | 2017-06-23 |
| 1356878565 | Peyton Glass | Optometrist | 8907 Wilshire Blvd Fl 3, Beverly Hills, CA 90211-1930 | 2017-05-18 |
| 1750545877 | Dalia Saadat | Optometrist | 9735 Wilshire Blvd Ste 204, Beverly Hills, CA 90212-2100 | 2008-07-17 |
| 1932247954 | Jay D Newcomer | Optometrist | 3636 N Lecanto Hwy, Beverly Hills, FL 34465-3513 | 2007-02-02 |
| 1073691010 | Lynn M. Seldon | Optometrist | 300 S Beverly Dr Ste 307, Beverly Hills, CA 90212-4806 | 2006-11-01 |
| 1316957723 | Lindsay R Harris | Optometrist | 450 N Roxbury Dr Fl 3, Beverly Hills, CA 90210-4232 | 2006-08-08 |
| 1134100878 | Steven Bradley Richlin | Optometrist | 8907 Wilshire Blvd, Third Floor, Beverly Hills, CA 90211-1937 | 2005-11-09 |
| 1538775051 | Hills Eyecare and Optical Plc | Optometrist | 31815 Southfield Rd Ste 12, Beverly Hills, MI 48025-5471 | 2020-09-21 |
| 1982232146 | Daniela Baumann | Optometrist | 450 N Bedford Dr Ste 101, Beverly Hills, CA 90210-4305 | 2020-03-31 |
| Find all providers in BEVERLY HILLS | ||||
| City | BEVERLY HILLS |
| Zip Code | 48025 |
Please comment or provide details below to improve the information on DR. ANGELA DENA ICEBERG.
| 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.