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DOMINIK WIETRZYNSKI D.D.S.
NPI 1750693149
Dentist in Warren, MI

Active since July 14, 2010PECOS Enrolled
11552 E 12 MILE RD, WARREN, MI 48093(586) 573-2533 Get Directions Write a Review

NPPES record last updated: September 8, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dominik Wietrzynski D.d.s. NPPES

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

DOMINIK WIETRZYNSKI D.D.S. (NPI 1750693149) is an individual dentist in Warren, Michigan, licensed in Michigan (2901020331) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750693149
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDOMINIK WIETRZYNSKICredential: D.D.S.
Location Address11552 E 12 MILE RDWarren, MI 48093-2644
Mailing Address11552 E 12 Mile RdWarren, MI 48093-2644 · (586) 573-2533
Phone(586) 573-2533
Sole ProprietorNo
Enumeration DateJuly 14, 2010
Last NPPES UpdateSeptember 8, 2011
✔ NPI 1750693149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in MI · 2901020331✔ Licensed in IL · 019.028405
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.
11552 E 12 MILE RD, Warren, MI 48093
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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)

Dominik Wietrzynski D.d.s. 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 48093 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 6

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

PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN,LLC
Dentist
11552 E 12 MILE RD
WARREN, MI 48093
Macomb County (586) 573-7500
AVNEET TAKHAR DDS
Dentist
11552 E 12 MILE RD
WARREN, MI 48093
Macomb County (586) 573-7500
WARREN DENTAL REFLECTIONS, PLC
Dentist (General Practice)
11552 E 12 MILE RD
WARREN, MI 48093
Macomb County (586) 573-7500
DALI AL SAUD
Dentist
11552 E 12 MILE RD
WARREN, MI 48093
Macomb County (586) 573-7500
JACOB SZYMANSKI
Dentist
11552 E 12 MILE RD
WARREN, MI 48093
Macomb County (586) 573-7500
DORCAS SAM-AYODELE DDS
Dentist (General Practice)
11552 E 12 MILE RD
WARREN, MI 48093
Macomb County (586) 573-7500

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 Dominik Wietrzynski's NPI number?

The NPI number for Dominik Wietrzynski is 1750693149. It was assigned to this individual provider in the NPPES registry on July 14, 2010.

Where is Dominik Wietrzynski located?

Dominik Wietrzynski practices at 11552 E 12 Mile Rd, Warren, MI 48093. The listed phone number is (586) 573-2533.

What is Dominik Wietrzynski's specialty?

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

Is Dominik Wietrzynski enrolled in Medicare?

Yes. Dominik Wietrzynski is registered in the Medicare PECOS enrollment system.

What insurance does Dominik Wietrzynski accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Delta Dental of Michigan and Humana list Dominik Wietrzynski 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 Dominik Wietrzynski was last updated on September 8, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.