MEDICARE: DR. THOMAS RICHARD GEBECK JR. D.D.S., M.S.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	16318	MI

General Provider Information

NPI Number	:	1467669333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS RICHARD GEBECK JR. D.D.S., M.S.

Provider Business Mailing Address
First Line	:	35046 WOODWARD AVE STE 200
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-0964
Country	:	US
Telephone Number	:	248-644-5400
Fax Number	:	248-644-4954

Provider Business Practice Location Address
First Line	:	35046 WOODWARD AVE STE 200
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-0964
Country	:	US
Telephone Number	:	248-644-5400
Fax Number	:	248-644-4954

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	12/16/2025

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