Dr Mario Endiakov, DMD is a
Student In An Organized Health Care Education/training Program based in Detroit, Michigan. Dr Mario Endiakov is licensed to practice in Michigan (license number 2951000970) and his current practice location is
2700 Martin Luther King Jr Blvd, Detroit, Michigan. He can be reached at his office (for appointments etc.) via phone at
(313) 494-6700.
NPI number for Dr Mario Endiakov is 1194217166 and his current mailing address is 2700 Martin Luther King Jr Blvd, Detroit, Michigan. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1194217166.
Healthcare Provider's Profile
| Full Name | Dr Mario Endiakov |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 2700 Martin Luther King Jr Blvd, Detroit, Michigan |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1194217166
- Provider Enumeration Date: 06/05/2018
- Last Update Date: 07/06/2024
Medical Identifiers
Medical identifiers for Dr Mario Endiakov such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194217166 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 019031843 (Illinois) | Secondary |
| 122300000X | Dentist | 2951000970 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 2951000970 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mario Endiakov is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mario Endiakov, DMD
2700 Martin Luther King Jr Blvd,
Detroit, MI 48208-2576
Ph: (313) 494-6700 | Dr Mario Endiakov, DMD
2700 Martin Luther King Jr Blvd,
Detroit, MI 48208-2576
Ph: (313) 494-6700 |
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