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D GARY WOLFORD DDS PC
NPI 1114229911
Oral & Maxillofacial Surgery in Saint Clair Shores, MI

Active since November 30, 2010
22811 MACK AVE, SUITE L-1, SAINT CLAIR SHORES, MI 48080(586) 777-1331(586) 777-2358 Get Directions Write a Review

NPPES record last updated: October 27, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About D Gary Wolford Dds Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

D GARY WOLFORD DDS PC (NPI 1114229911) is a healthcare organization registered as an oral & maxillofacial surgery in Saint Clair Shores, Michigan and active in the NPI registry since November 2010. The organization lists Donald G Wolford, Owner, as its authorized official.

NPPES Registry Identity

NPI1114229911
Entity TypeOrganization
Primary Taxonomy204E00000X
Legal Business NameD GARY WOLFORD DDS PC
Location Address22811 MACK AVE, SUITE L-1Saint Clair Shores, MI 48080-2021
Mailing Address22811 Mack Ave, Suite L-1Saint Clair Shores, MI 48080-2021 · (586) 777-1331 · Fax (586) 777-2358
Phone(586) 777-1331
Fax(586) 777-2358
Organization SubpartNo
Authorized OfficialDonald G WolfordOwner · (586) 777-1331
Enumeration DateNovember 30, 2010
Last NPPES UpdateOctober 27, 2015
✔ NPI 1114229911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in MI · 2901010985
Definition
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.
22811 MACK AVE, Saint Clair Shores, MI 48080
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Other Identifiers 3

Medicaid102991246MI
Other9755060680MI · Blue Cross Blue Shield
Medicare UPINU23186MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

D Gary Wolford Dds Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to D Gary Wolford DDS PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Donald Wolford, DDS
Oral Surgery
NPI 1659355063
22811 MACK AVE L1
St Clair Shores, MI 48080
(586) 777-1331
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is D Gary Wolford Dds PC's NPI number?

The NPI number for D Gary Wolford Dds PC is 1114229911. It was assigned to this organization in the NPPES registry on November 30, 2010.

Where is D Gary Wolford Dds PC located?

D Gary Wolford Dds PC is located at 22811 Mack Ave Suite L-1, Saint Clair Shores, MI 48080. The listed phone number is (586) 777-1331.

What is D Gary Wolford Dds PC's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is D Gary Wolford Dds PC enrolled in Medicare?

Yes. D Gary Wolford Dds PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through D Gary Wolford Dds PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Oral Surgery) reassigns their Medicare billing to D Gary Wolford Dds PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does D Gary Wolford Dds PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list D Gary Wolford Dds PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for D Gary Wolford Dds PC was last updated on October 27, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.