DR. ANDRES WILSON SETAPUTRI DDS
NPI 1710393095
Dentist - General Practice in Southgate, MI

Q: What is Andres Setaputri's NPI number?

The NPI number for Andres Setaputri is 1710393095. It was assigned to this individual provider in the NPPES registry on July 7, 2014.

Q: What is Andres Setaputri's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Andres Setaputri was last updated on July 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since July 07, 2014PECOS Enrolled

16060 HOLZ DR UNIT 77, SOUTHGATE, MI 48195(734) 250-1473 Get Directions Write a Review

NPPES record last updated: July 7, 2014. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Dr. Andres Wilson Setaputri Dds NPPES

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

DR. ANDRES WILSON SETAPUTRI DDS (NPI 1710393095) is an individual general practice provider in Southgate, Michigan, licensed in Michigan (2901021307) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710393095

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. ANDRES WILSON SETAPUTRICredential: DDS

Location Address16060 HOLZ DR UNIT 77Southgate, MI 48195-2991

Mailing Address16060 Holz Dr Unit 77Southgate, MI 48195-2991 · (734) 250-1473

Phone(734) 250-1473

Sole ProprietorYes

Enumeration DateJuly 7, 2014

✔ NPI 1710393095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MI · 2901021307

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

16060 HOLZ DR UNIT 77, Southgate, MI 48195

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Michigan.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)

Dr. Andres Wilson Setaputri 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 48195 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.

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 Andres Setaputri's NPI number?

The NPI number for Andres Setaputri is 1710393095. It was assigned to this individual provider in the NPPES registry on July 7, 2014.

Where is Andres Setaputri located?

Andres Setaputri practices at 16060 Holz Dr Unit 77, Southgate, MI 48195. The listed phone number is (734) 250-1473.

What is Andres Setaputri's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Andres Setaputri enrolled in Medicare?

Yes. Andres Setaputri is registered in the Medicare PECOS enrollment system.

What insurance does Andres Setaputri accept?

Health plans from Delta Dental of Michigan list Andres Setaputri 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 Andres Setaputri was last updated on July 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.