Individual provider Active NPI

Jonathan Saher Zora, DDS

  • Dentist
  • Dearborn, MI
National Provider Identifier
1003471517
Registry record updated Jun 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901600541 Issued in MI
Practice address
22801 Newman St
Dearborn, MI 48124-2200
Phone
(313) 274-8522
NPI assigned
May 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 2901600541 MI Primary

Addresses

Primary practice location

22801 Newman St
Dearborn, MI 48124-2200

Mailing address

6318 Orchard Woods Dr
West Bloomfield, MI 48324-3287
Phone (248) 207-6972

Other practice location 1

11900 E 12 Mile Rd Ste 210
Warren, MI 48093-3490
Phone (313) 499-4962

Other practice location 2

735 N Milford Rd
Milford, MI 48381-1536
Phone (248) 685-9449

Other practice location 3

3589 Fort St
Wyandotte, MI 48192-6315
Phone (734) 281-1414

Other practice location 4

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
Phone (313) 494-6647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190726001827 MI Order and Referring Only - DentistPractitioner - Dentist 3173859253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901600541MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Periodintic PLLC Past Accepting new patients
Periodontic PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655596800000",
    "number": "1003471517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6318 ORCHARD WOODS DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483243287",
            "telephone_number": "248-207-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22801 NEWMAN ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242200",
            "telephone_number": "313-274-8522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11900 E 12 Mile Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480933490",
            "country_code": "US",
            "telephone_number": "313-499-4962",
            "fax_number": "313-499-4953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "735 N Milford Rd",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MI",
            "postal_code": "483811536",
            "country_code": "US",
            "telephone_number": "248-685-9449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3589 Fort St",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481926315",
            "country_code": "US",
            "telephone_number": "734-281-1414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482082576",
            "country_code": "US",
            "telephone_number": "313-494-6647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZORA",
        "first_name": "JONATHAN",
        "middle_name": "SAHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-09",
        "last_updated": "2022-06-19",
        "certification_date": "2022-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.