MEDICARE: SARAH JOBE MUSGROVE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	2901603076	MI

General Provider Information

NPI Number	:	1033040423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH JOBE MUSGROVE DDS

Provider Business Mailing Address
First Line	:	3434 BURBANK DR
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-1594
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18618 MIDDLEBELT RD STE 105
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48152-3528
Country	:	US
Telephone Number	:	248-579-0618
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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