NPIMap

Organization Active NPI

Shoreline Dental Center

  • Dentist
  • Saint Clair Shores, MI
National Provider Identifier
1063609220
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901007772 Issued in MI
Legal business name
SHORELINE DENTAL CENTER
Practice address
31118 Harper Ave
Saint Clair Shores, MI 48082-1950
Phone
(586) 285-2000
Fax
(586) 285-2499
NPI assigned
Oct 1, 2007
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Samuel Paul Weiner, DDS
Title
Owner
Phone
(586) 285-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901007772 MI Primary

Addresses

Primary practice location

31118 Harper Ave
Saint Clair Shores, MI 48082-1950

Mailing address

31118 Harper Ave
Saint Clair Shores, MI 48082-1950
Phone (586) 285-2000

National Provider Directory

National Provider Directory

Locations

31118 Harper Ave
St Clr Shores, MI 48082
Phone (586) 285-2000

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1063609220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31118 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821950",
            "telephone_number": "586-285-2000",
            "fax_number": "586-285-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31118 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821950",
            "telephone_number": "586-285-2000",
            "fax_number": "586-285-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-285-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901007772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.