Organization Active NPI

Edward R. Essayan DDS, PC (Professional Corporation)

  • Dentist
  • West Bloomfield, MI
National Provider Identifier
1063740108
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901009679 Issued in MI
Legal business name
EDWARD R. ESSAYAN DDS, PC (PROFESSIONAL CORPORATION)
Practice address
6161 Orchard Lake Rd
Suite 200
West Bloomfield, MI 48322-2384
Phone
(248) 851-3767
Fax
(248) 865-9455
NPI assigned
Dec 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Authorized official

Name
Dr. Edward R. Essayan, DDS - ORTHODONTIST
Title
DDS - Orthodontist - President
Phone
(248) 851-3767

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901009679 MI Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 2901009679 MI

Addresses

Primary practice location

6161 Orchard Lake Rd
Suite 200
West Bloomfield, MI 48322-2384

Mailing address

6161 Orchard Lake Rd
Suite 200
West Bloomfield, MI 48322-2384
Phone (248) 851-3767

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1063740108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 ORCHARD LAKE RD",
            "address_2": "SUITE 200",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222384",
            "telephone_number": "248-851-3767",
            "fax_number": "248-865-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 ORCHARD LAKE RD",
            "address_2": "SUITE 200",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222384",
            "telephone_number": "248-851-3767",
            "fax_number": "248-865-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD R. ESSAYAN DDS, PC (PROFESSIONAL CORPORATION)",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "ESSAYAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "DDS - ORTHODONTIST - PRESIDENT",
        "authorized_official_telephone_number": "248-851-3767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS - ORTHODONTIST"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901009679",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901009679",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.