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John Metodi Pogoncheff

Dentist

Dental Providers

2628 Lake Lansing Rd Ste 101, Lansing, MI 48912-3668

PECOS Enrollment

This provider is enrolled in PECOS as JOHN POGONCHEFF.

Based on the most recent information from CMS, provider John Metodi Pogoncheff is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1821381989
Provider Type
Individual
Full Name
Pogoncheff, John Metodi
Title
Dr.
Credential
DDS

Gender
Male
Sole Proprietor
No
Enumeration Date
5/24/2011
Last Updated
5/24/2011

Contact Information

Practice Location

2628 Lake Lansing Rd Ste 101, Lansing, MI 48912-3668

(517) 482-5636

(517) 482-5637

Mailing Location

2628 Lake Lansing Rd Ste 101, Lansing, MI 48912-3668

(517) 482-5636

(517) 482-5637

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 2901020411 Michigan

John Metodi Pogoncheff

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Hall-Tate, Lauren Ann

Vuillemot, Barbara A

Bdd Of Michigan P.C.

Erhard, Robert W.

Vuillemot, William C

Vakade, Chinmay Dilip

Holly Scott-Hetchler, Dds, Pc

Volunteers Of America Michigan

Gill Dental Pc

Bdd Of Michigan P.C.