Provider Demographics
NPI:1841272754
Name:HILDEBRAND, JOSEPH M (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:HILDEBRAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50154 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3136
Mailing Address - Country:US
Mailing Address - Phone:586-731-9050
Mailing Address - Fax:586-731-9056
Practice Address - Street 1:50154 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-3136
Practice Address - Country:US
Practice Address - Phone:586-731-9050
Practice Address - Fax:586-731-9056
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010135631223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI970F31085OtherBLUE CROSS BLUE SHIELD
MIJH013563OtherLICENSE NUMBER
MI2773480Medicaid
MI2990552Medicaid
MIJH013563OtherLICENSE NUMBER
MI2773480Medicaid