DAVID FIVENSON, M.D.DERMATOLOGY, PLLC
NPI 1205037454
Dermatology - Clinical & Laboratory Dermatological Immunology in Ann Arbor, MI
NPI Status: Active since May 29, 2007
Contact Information
3200 W LIBERTY RD STE C5
ANN ARBOR, MI
ZIP 48103
Phone: (734) 222-9630
- Organization
- Dermatology
- Clinical & Laboratory Dermatological Imm...
- CLIA Number: 23D1007029
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-05-2026
About DAVID FIVENSON, M.D.DERMATOLOGY, PLLC
This page provides the complete NPI Profile along with additional information for David Fivenson, M.d.dermatology, Pllc, a provider established in Ann Arbor, Michigan operating as a Dermatology, focusing in clinical & laboratory dermatological immunology . The healthcare provider is registered in the NPI registry with number 1205037454 assigned on May 2007. The practitioner's primary taxonomy code is 207NI0002X with license number DF404817 (MI). The provider is registered as an organization and their NPI record was last updated March 2026. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is David Fivenson Md (President)
- NPI
- 1205037454
- Provider Name
- DAVID FIVENSON, M.D.DERMATOLOGY, PLLC
- Entity Type
- Organization
- Location Address
- 3200 W LIBERTY RD STE C5 ANN ARBOR, MI 48103
- Location Phone
- (734) 222-9630
- Mailing Address
- 3200 W LIBERTY RD STE C5 ANN ARBOR, MI 48103
- Mailing Phone
- (734) 222-9630
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-29-2007
- Last Update Date
- 03-25-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology Clinical & Laboratory Dermatological Immunology
- Taxonomy Code
- 207NI0002X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- DF404817
- License State
- MI
- Taxonomy Description
- A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| DF404817 | OTHER (01) | MI | STATE LICENSE |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D1007029
- Facility Type
- Physician Office
- Certificate Effective Date
- December 06, 2024
- Certificate Expiration Date
- December 05, 2026
- Laboratory Director
- DAVID P. FIVENSON
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to David Fivenson, M.d.dermatology, Pllc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1205037454, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 46 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
ANN ARBOR, MI 48103
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205037454, enumerated as an "organization" on May 29, 2007.
The provider is located at 3200 W LIBERTY RD STE C5 ANN ARBOR, MI 48103 and the phone number is (734) 222-9630.
Dermatology with taxonomy code 207NI0002X and a focus in Clinical & Laboratory Dermatological Immunology.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
