DONALD GARY WOLFORD (NPI# 1659355063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659355063 |
| Entity Type | Individual |
| Full Name | DONALD GARY WOLFORD |
| Other Name | D GARY WOLFORD |
| Credential | DDS |
| Practice Address |
22811 Mack Ave L1 St Clair Shores MI 48080-2021 |
| Practice Telephone | 5867771331 |
| Practice Fax Number | 5867772358 |
| Mailing Telephone | 5867771331 |
| Mailing Fax Number | 5867772358 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2010-07-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 2901010985 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 102991246 | 05 | |
| MI | BLUE CROSS BLUE SHIELD | 9755060680 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154517241 | Donald Eugene Wolford | Counselor | 116 Market St, New Bern, NC 28560-6704 | 2007-09-21 |
| Street Address |
22811 MACK AVE L1 |
| City | ST CLAIR SHORES |
| State | MI |
| Zip Code | 48080-2021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482084 | Farrah Aleema Rajab | Family Medicine | 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 | 2020-06-22 |
| 1558986141 | Julia Anastazja Krakowska | Family Medicine | 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 | 2020-06-10 |
| 1972073567 | Joyce Stepnak | Social Worker | 19611 E. 8 Mile Rd, Scs, MI 48080 | 2018-11-27 |
| 1487134177 | Bonnie Girson | Social Worker | 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 | 2018-08-21 |
| 1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
| 1730564055 | Mary Rose Giroux | Psychologist | 22516 Overlake St, St. Clair Shores, MI 48080 | 2015-07-28 |
| 1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
| 1497156228 | Kelly Zalewski | Social Worker | 24631 Jefferson Ave, Saint Clair Shores, MI 48080 | 2014-09-11 |
| 1669871364 | Mallory Margret Gordon | Psychologist | 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 | 2014-08-19 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| Find all providers in zip 48080 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922115633 | Nick Leone | Oral & Maxillofacial Surgery | 28018 Harper Avenue, St Clair Shores, MI 48081 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760900120 | Cynthia A Rider Dmd Pllc | Oral & Maxillofacial Surgery | 2545 Spring Arbor Road, Suite 202, Jackson, MI 49203 | 2017-09-06 |
| 1881792786 | James W Lepczyk | Oral & Maxillofacial Surgery | 31100 Telegraph, Suite 100, Bingham Farms, MI 48025 | 2006-09-21 |
| 1558472332 | Richard F Scott Dds Ms PC | Oral & Maxillofacial Surgery | 203 S Zeeb Road, Suite 101, Ann Arbor, MI 48103 | 2006-08-31 |
| 1598772626 | Oral & Maxillofacial Surgery Associates of Western Michigan Plc | Oral & Maxillofacial Surgery | 2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785 | 2006-08-02 |
| 1831113125 | Jeffery Mcfadden | Oral & Maxillofacial Surgery | 33111 W. Seven Mile Rd., Livonia, MI 48152 | 2006-07-27 |
| 1215950100 | William S Bloom | Oral & Maxillofacial Surgery | 11300 East Thirteen Mile Road, Warren, MI 48093 | 2006-07-25 |
| 1609809250 | Richard Peter Bartling | Oral & Maxillofacial Surgery | 3011 Abigail Ln, Midland, MI 48640 | 2006-07-08 |
| 1710949953 | Robert Harry Burke | Oral & Maxillofacial Surgery | 2260 S Huron Pkwy, Ann Arbor, MI 48104-5151 | 2006-04-04 |
| 1497728380 | Brian H Cohen | Oral & Maxillofacial Surgery | 2120 Monroe St, Dearborn, MI 48124-2943 | 2006-02-10 |
| 1518949742 | Gregory M Nielsen | Oral & Maxillofacial Surgery | 26111 Woodward Ave, Huntington Woods, MI 48070-1330 | 2005-11-15 |
| Find all providers with the same taxonomy | ||||
| City | ST CLAIR SHORES |
| Zip Code | 48080 |
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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.