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: July 19, 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
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

Secondary Practice Location 1

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

Accepted Insurance

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Dentist (General Practice)
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Dentist
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Dentist (General Practice)
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Dentist
1795 W STADIUM BLVD
ANN ARBOR, MI 48103
Dentist
1795 W STADIUM BLVD
ANN ARBOR, MI 48103

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1881255966, enumerated as an "individual" on June 27, 2019.

The provider is located at 1795 W STADIUM BLVD ANN ARBOR, MI 48103 and the phone number is (734) 677-8700.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: BEST Life, Blue Cross and Blue Shield of Montana,. Please consult your insurance carrier or call the provider to verify.