MEDICARE: MR. JASON B INGBER 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	16729	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801969225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON B INGBER DDS

Provider Business Mailing Address
First Line	:	4664 W WALTON
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48329
Country	:	US
Telephone Number	:	248-674-0418
Fax Number	:	248-674-4518

Provider Business Practice Location Address
First Line	:	4664 W WALTON BLVD
Second Line	:
City	:	WATERFORD TWP
State	:	MI
Zip	:	48329-3537
Country	:	US
Telephone Number	:	248-674-0418
Fax Number	:	248-674-4518

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	11/04/2019

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