MEDICARE: DR. JOSEPH M HILDEBRAND 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	2901013563	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	970F31085	OTHER	MI	BLUE CROSS BLUE SHIELD
2	JH013563	OTHER	MI	LICENSE NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841272754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH M HILDEBRAND DDS

Provider Business Mailing Address
First Line	:	50154 SCHOENHERR RD
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48315-3136
Country	:	US
Telephone Number	:	586-731-9050
Fax Number	:	586-731-9056

Provider Business Practice Location Address
First Line	:	50154 SCHOENHERR RD
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48315-3136
Country	:	US
Telephone Number	:	586-731-9050
Fax Number	:	586-731-9056

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

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	07/03/2019

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