DONALD GARY WOLFORD (DDS) – Oral & Maxillofacial Surgery (D.M.D.), NPI 1659355063

DONALD GARY WOLFORD (DDS) is a healthcare provider. based in St clair shores, Michigan. specializing in ORAL SURGERY. They hold the professional credentials DDS. They hold a License No. 2901010985 (MI). The NPI Number for DONALD GARY WOLFORD (DDS) is 1659355063

Main info

Male
Sole Proprietor
59 Years Of Experience
Accepts Medicare Assignment
Name
DONALD GARY WOLFORD (DDS)
NPI
1659355063
Phone
(586) 777-1331
Address
22811 MACK AVE
Enumeration Date
30 November 2005
Last Update Date
13 July 2010

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5867771331
Graduation Year
1967 (59 years ago)
PAC ID
0840487690
Professional Enrollment ID
I20101207000249
Address ID
MI480802052SA22811AVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

90 ORAL SURGERY in MI

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Provider Addresses for DONALD GARY WOLFORD (DDS)

  • Passport Health St. Clair Shores Travel Clinic, 22811, Greater Mack Avenue, Saint Clair Shores, Macomb County, Michigan, 48080, United States

    L1

    ST CLAIR SHORES, MI 480802021

    Phone: (586) 777-1331

    Fax: (586) 777-2358

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-12-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101207000249IOral SurgeryMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes3817$0
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Insurance plans in this area (ZIP 48080)

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Reviews

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Frequently asked questions

What is DONALD GARY WOLFORD (DDS)'s NPI number?
DONALD GARY WOLFORD (DDS)'s NPI is 1659355063 — the number used across U.S. healthcare to identify this provider.
Would DONALD GARY WOLFORD (DDS) appear as active to a payer?
You can treat DONALD GARY WOLFORD (DDS) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to DONALD GARY WOLFORD (DDS)?
DONALD GARY WOLFORD (DDS)'s specialty line reads Oral & Maxillofacial Surgery (D.M.D.). Clinical services aligned with this taxonomy classification.
Is DONALD GARY WOLFORD (DDS) located near St Clair Shores?
DONALD GARY WOLFORD (DDS) currently maps to St Clair Shores, Michigan in this extract.
Does DONALD GARY WOLFORD (DDS) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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