Individual provider Active NPI

Monica Malak Assad, D.D.S.

  • Dentist
  • Warren, MI
National Provider Identifier
1043594666
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020415 Issued in MI
Practice address
31690 Hoover Rd Ste B
Warren, MI 48093-7653
Phone
(586) 619-3920
Fax
(586) 619-3921
NPI assigned
Sep 30, 2011
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020415 MI Primary

Addresses

Primary practice location

31690 Hoover Rd Ste B
Warren, MI 48093-7653

Mailing address

31690 Hoover Rd Ste B
Warren, MI 48093-7653
Phone (586) 619-3920

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

LicenseStateTypeSpecialty
2901020415MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dearborn Community Dental Center P.C. Past Accepting new patients

Organizations & group practices 1

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": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1043594666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31690 HOOVER RD STE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480937653",
            "telephone_number": "586-619-3920",
            "fax_number": "586-619-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31690 HOOVER RD STE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480937653",
            "telephone_number": "586-619-3920",
            "fax_number": "586-619-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSAD",
        "first_name": "MONICA",
        "middle_name": "MALAK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.