1. Home
  2. Directory
  3. Michigan
  4. Warren
  5. Dentist
  6. NPI Profile

MR. MICHAEL JACK DDS
NPI 1558453399
Dentist in Warren, MI

Active since September 29, 2006PECOS Enrolled
13403 13 MILE RD, WARREN, MI 48088(586) 979-2800(586) 979-2720 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Michael Jack Dds NPPES

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

MR. MICHAEL JACK DDS (NPI 1558453399) is an individual dentist in Warren, Michigan, licensed in Michigan (2901018160) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558453399
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameMR. MICHAEL JACKCredential: DDS
Location Address13403 13 MILE RDWarren, MI 48088
Mailing Address13403 13 Mile RdWarren, MI 48088 · (586) 979-2800 · Fax (586) 979-2720
Phone(586) 979-2800
Fax(586) 979-2720
Sole ProprietorNo
Enumeration DateSeptember 29, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1558453399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in MI · 2901018160
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
13403 13 MILE RD, Warren, MI 48088
Open in Google Maps ↗

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, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Michael Jack Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48088 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MARK A BOUCHILLON DDS
Dentist
13403 13 MILE RD
WARREN, MI 48088
Macomb County (586) 979-2800
MR. JONATHAN HURST DDS
Dentist
13403 13 MILE RD
WARREN, MI 48088
Macomb County (586) 979-2800
MRS. LAURA ZETU DDS
Dentist (Periodontics)
13403 13 MILE RD
WARREN, MI 48088
Macomb County (586) 979-2800
MR. DAVID J BARTOLOVIC DDS
Dentist (Prosthodontics)
13403 13 MILE RD
WARREN, MI 48088
Macomb County (586) 979-2800
MRS. DANIELLE GEHLERT DDS
Dentist
13403 13 MILE RD
WARREN, MI 48088
Macomb County (586) 979-2800
MR. STEVEN HANE DDS
Dentist
13403 13 MILE RD
WARREN, MI 48088
Macomb County (586) 979-2800
MR. TAE-JU OH DDS MS
Dentist (Periodontics)
13403 13 MILE RD
WARREN, MI 48088
Macomb County (586) 979-2800
MRS. PAULA OTTAWAY DDS
Dentist
13403 13 MILE RD
WARREN, MI 48088
Macomb County (586) 979-2800

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 Michael Jack's NPI number?

The NPI number for Michael Jack is 1558453399. It was assigned to this individual provider in the NPPES registry on September 29, 2006.

Where is Michael Jack located?

Michael Jack practices at 13403 13 Mile Rd, Warren, MI 48088. The listed phone number is (586) 979-2800.

What is Michael Jack's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Michael Jack enrolled in Medicare?

Yes. Michael Jack is registered in the Medicare PECOS enrollment system.

What insurance does Michael Jack accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and BEST Life and 15 other insurers list Michael Jack 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 Michael Jack was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.