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JUSTIN DISTELRATH
NPI 1881255966
Dentist - General Practice in Ann Arbor, MI

Active since June 27, 2019
1795 W STADIUM BLVD, ANN ARBOR, MI 48103(734) 677-8700(734) 839-4137 Get Directions Write a Review

NPPES record last updated: September 12, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Justin Distelrath NPPES

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

JUSTIN DISTELRATH (NPI 1881255966) is an individual general practice provider in Ann Arbor, Michigan, licensed in Michigan (2901023205) and active in the NPI registry since June 2019. He maintains a secondary practice location in Ann Arbor.

NPPES Registry Identity

NPI1881255966
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJUSTIN DISTELRATH
Location Address1795 W STADIUM BLVDAnn Arbor, MI 48103-5290
Mailing Address1795 W Stadium BlvdAnn Arbor, MI 48103-5290 · (734) 677-8700 · Fax (734) 839-4137
Phone(734) 677-8700
Fax(734) 839-4137
Sole ProprietorNo
Enumeration DateJune 27, 2019
Last NPPES UpdateSeptember 12, 2022
NPPES CertifiedSeptember 12, 2022
✔ NPI 1881255966 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 · 2901023205
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.
1795 W STADIUM BLVD, Ann Arbor, MI 48103
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Secondary Practice Location 1

Location 12365 S Huron PkwyAnn Arbor, MI 48104-5156 · Phone (734) 677-8700 · Fax (734) 839-4137

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Other Providers at the Same Location NPPES 5

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

KRISTIN F. NICKODEMUS, DDS, PLC
Dentist (General Practice)
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Washtenaw County (734) 769-4121
DR. BONNIE PRITI PATEL D.D.S.
Dentist
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Washtenaw County (734) 761-2144
LIANE RACELIS DDS
Dentist
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Washtenaw County (734) 662-3222
DR. RICHARD HAN DDS
Dentist (General Practice)
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Washtenaw County (734) 769-4121
ANN ARBOR SMILES HADDOCK PLLC
Dentist
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Washtenaw County (734) 662-3222

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 Justin Distelrath's NPI number?

The NPI number for Justin Distelrath is 1881255966. It was assigned to this individual provider in the NPPES registry on June 27, 2019.

Where is Justin Distelrath located?

Justin Distelrath practices at 1795 W Stadium Blvd, Ann Arbor, MI 48103. The listed phone number is (734) 677-8700.

What is Justin Distelrath's specialty?

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

What insurance does Justin Distelrath accept?

Health plans from BEST Life, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 8 other insurers list Justin Distelrath 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 Justin Distelrath was last updated on September 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.