Active NPI
Luiz Carlos Magno Filho, DDS, MSC
- Dentist
- Detroit, MI
National Provider Identifier
1023816972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2952000875
- Practice address
- 2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576 - Phone
- (313) 993-1000
- NPI assigned
- Mar 6, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 2952000875 | MI | |
| Dentist | 122300000X | 2952000875 | MI | Primary |
Addresses
Primary practice location
2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
Mailing address
2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576
Phone (313) 993-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2952000875 | MI | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741219200000",
"number": "1023816972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 MARTIN LUTHER KING JR BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482082576",
"telephone_number": "313-993-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 MARTIN LUTHER KING JR BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482082576",
"telephone_number": "313-993-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNO FILHO",
"first_name": "LUIZ CARLOS",
"name_prefix": "Dr.",
"credential": "DDS, MSC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-06",
"last_updated": "2025-03-06",
"certification_date": "2025-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "MI",
"license": "2952000875",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2952000875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.