Kevin J Potocsky, DDS,PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KEVIN J POTOCSKY, DDS,PC

Practice address

7720 Allen Rd
Allen Park, MI 48101-1928

Phone

(313) 381-1633

Fax

(313) 381-2504

NPI assigned

Oct 20, 2020

Organization subpart

No

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

Authorized official

Name

Janis Denise Boedy

Title

Treatment Coordinator

Phone

(313) 381-1633

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1023617289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011928",
            "telephone_number": "313-381-1633",
            "fax_number": "313-381-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011928",
            "telephone_number": "313-381-1633",
            "fax_number": "313-381-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN J POTOCSKY, DDS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "BOEDY",
        "authorized_official_first_name": "JANIS",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "313-381-1633"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.