Brilliant Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

2901016118 Issued in MI

Legal business name

BRILLIANT DENTISTRY

Practice address

28050 Ford Rd
Suite D
Garden City, MI 48135-2967

Phone

(734) 956-5604

Fax

(734) 956-5284

NPI assigned

Jul 5, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Adnan Khazaal, D.D.S.

Title

Owner

Phone

(734) 956-5604

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1013357094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28050 FORD RD",
            "address_2": "SUITE D",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352967",
            "telephone_number": "734-956-5604",
            "fax_number": "734-956-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28050 FORD RD",
            "address_2": "SUITE D",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352967",
            "telephone_number": "734-956-5604",
            "fax_number": "734-956-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRILLIANT DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-05",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "KHAZAAL",
        "authorized_official_first_name": "ADNAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-956-5604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Garden City, MI
• Providers in Garden City, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.