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NPI Code Detail

MEDICARE: CANTON HEALTHY SMILES PLLC

MEDICARE: CANTON HEALTHY SMILES PLLC
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1760365563
Entity Type Code : Organization
Provider Name (Legal Business Name) : CANTON HEALTHY SMILES PLLC
Provider Business Mailing Address
First Line : PO BOX 734753
Second Line :
City : DALLAS
State : TX
Zip : 75373-4753
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4903 S BECK RD
Second Line : STE #1
City : CANTON
State : MI
Zip : 48188
Country : US
Telephone Number : 734-359-6399
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOHNATHAN BIRCHMEIER
Credential : DDS
Telephone Number : 734-359-6399
Provider Enumeration Date : 07/29/2025
Last Update Date : 03/03/2026

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Directions to “CANTON HEALTHY SMILES PLLC ” Practice Location

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