DONALD GARY WOLFORD DDS NPI 1659355063

NPI Information

  • NPI: 1659355063
  • Provider Name: DONALD GARY WOLFORD, DDS
  • Classification: Oral & Maxillofacial Surgery - 204E00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 22811 MACK AVE
    L1
    ST CLAIR SHORES, MI
    ZIP 48080
  • Phone: (586) 777-1331

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NPI Details

Donald Gary Wolford, DDS is an oral maxillofacial surgery in St Clair Shores, MI with 59 years of experience. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. Donald Gary Wolford, DDS NPI is 1659355063. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1967

The provider's business location address is:

22811 MACK AVE
L1
ST CLAIR SHORES, MI
ZIP 48080-021
Phone: (586) 777-1331
Fax: (586) 777-2358

The NPI 1659355063 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • X-ray of body plane (HCPCS:76100)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • X-ray of lower jaws, upper jaws and teeth (HCPCS:70355)
  • Imaging of jaws and skull (HCPCS:70350)
  • X-ray of face bones, 1-2 views (HCPCS:70140)
  • X-ray of skull, 1-3 views (HCPCS:70250)
  • X-ray of jaw joints on both sides of mouth (HCPCS:70330)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)

The enumeration date for this NPI number is 11/30/2005 and was last updated on 7/13/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1204E00000XOral & Maxillofacial Surgery2901010985MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
19755060680OTHERMICHIGANBLUE CROSS BLUE SHIELD
2102991246MEDICAIDMICHIGAN
30M92420MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
4U23186MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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