DOMINIK WIETRZYNSKI D.D.S.
NPI 1750693149
Dentist in Warren, MI
NPI Status: Active since July 14, 2010
Contact Information
11552 E 12 MILE RD
WARREN, MI
ZIP 48093
Phone: (586) 573-2533
- Individual
- Male
- Dentist
- Accepts Insurance
- PECOS Enrolled
About DOMINIK WIETRZYNSKI
This page provides the complete NPI Profile along with additional information for Dominik Wietrzynski, a provider established in Warren, Michigan with a medical specialization in Dentist. The healthcare provider is registered in the NPI registry with number 1750693149 assigned on July 2010. The practitioner's primary taxonomy code is 122300000X with license number 2901020331 (MI). The provider is registered as an individual and his NPI record was last updated 14 years ago.
- NPI
- 1750693149
- Provider Name
- DOMINIK WIETRZYNSKI D.D.S.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 11552 E 12 MILE RD WARREN, MI 48093
- Location Phone
- (586) 573-2533
- Mailing Address
- 11552 E 12 MILE RD WARREN, MI 48093
- Mailing Phone
- (586) 573-2533
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-14-2010
- Last Update Date
- 09-08-2011
- Code Navigator
A dentist like Dominik Wietrzynski is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist
- Taxonomy Code
- 122300000X
- Type
- Dental Providers
- License No.
- 2901020331
- License State
- MI
- Taxonomy Description
- A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 122300000X | Dental Providers | Dentist | 019.028405 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue HSA Bronze - PPO
- Blue Protect - PPO
- Blue Saver Bronze - PPO
- Blue Value Gold - PPO
- Blue Value Silver - PPO
- Blue Access Gold for Business - PPO
- Blue Choice Platinum for Business - PPO
- Blue HSA Silver for Business - PPO
- Blue Saver Bronze for Business - PPO
- Blue Saver Gold for Business - PPO
- Blue Secure Gold for Business - PPO
- Blue Secure Silver for Business - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- Blue Dental EPO 80/50/50 (0/0/0) - EPO
- Blue Dental PPO 100/50/50 (50/50/50) - PPO
- Blue Dental PPO 100/70/50 (80/60/50) - PPO
- Blue Dental PPO 80/50/50 (50/50/50) - PPO
- Blue Dental PPO Pediatric 80/50/50 (50/50/50) - PPO
- Blue Dental PPO Plus 80/60/50 - PPO
- Delta Dental Individual Pediatric-Only PPO, EHB Certified - PPO
- Delta Dental Individual PPO Bronze Plan, EHB Certified - PPO
- Delta Dental Individual PPO Gold Plan, EHB Certified - PPO
- Delta Dental Individual PPO Silver Plan, EHB Certified - PPO
- Choice PPO Basic - PPO
- Choice PPO Basic Kids - PPO
- Choice PPO Plus - PPO
- Choice PPO Premium - PPO
- Choice PPO Premium Kids - PPO
- Choice PPO Preventive - PPO
- Guardian Essentials for Families and Individuals - PPO
- Guardian Preventive Plus for Families and Individuals - PPO
- Guardian Select for Families and Individuals - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Humana Dental Smart Choice Basic - PPO
- Humana Dental Smart Choice- Lite - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Dominik Wietrzynski is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 48093 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.76
- Minimum New Patient Price $58.04
- Maximum New Patient Price $177.36
- Average New Patient Copayment $22.69
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $72.38
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $143.49
- Average Established Patient Copayment $18.09
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $35.87
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Reviews for DOMINIK WIETRZYNSKI D.D.S.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 6 | 9 | 3 | 1 | 4 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 12 | 9 | 6 | 1 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 1 + 2 + 9 + 6 + 1 + 8 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1750693149 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1629230859 | WARREN DENTAL REFLECTIONS, PLC Organization | Dentist (General Practice) | 11552 E 12 MILE RD WARREN, MI 48093 (586) 573-7500 |
| 1629473996 | DALI AL SAUD Individual | Dentist | 11552 E 12 MILE RD WARREN, MI 48093 (586) 573-7500 |
| 1770933913 | JACOB SZYMANSKI Individual | Dentist | 11552 E 12 MILE RD WARREN, MI 48093 (586) 573-7500 |
| 1164771481 | PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN,LLC Organization | Dentist | 11552 E 12 MILE RD WARREN, MI 48093 (586) 573-7500 |
| 1467182261 | AVNEET TAKHAR DDS Individual | Dentist | 11552 E 12 MILE RD WARREN, MI 48093 (586) 573-7500 |
| 1831932748 | DORCAS SAM-AYODELE DDS Individual | Dentist (General Practice) | 11552 E 12 MILE RD WARREN, MI 48093 (586) 573-7500 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750693149, enumerated in the NPI registry as an "individual" on July 14, 2010
The provider is located at 11552 E 12 Mile Rd Warren, Mi 48093 and the phone number is (586) 573-2533
The provider's speciality is Dentist with taxonomy code 122300000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).
Medicare beneficiaries should expect a typical cost of $90.76 with an average copayment of $22.69 for new patient appointments. Established patients should expect a typical charge of $72.38 and an average copayment of 18.09. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on July 14, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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