Facial Beauty Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901013824 Issued in MI

Legal business name

FACIAL BEAUTY DENTAL, PLLC

Practice address

3255 W Maple Rd
Wixom, MI 48393-4585

Phone

(248) 669-4141

NPI assigned

Feb 24, 2015

Last updated

Feb 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gordon Phillip Smith, D.D.S.NPI 1073516712

Title

Owner

Phone

(248) 669-4141

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Gordon Phillip Smith, D.D.S.

  • General Practice Dentistry
  • Wixom, MI
  • NPI 1073516712
  Authorized official Same address or phone

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1063804334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 W MAPLE RD",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483934585",
            "telephone_number": "248-669-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 W MAPLE RD",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483934585",
            "telephone_number": "248-669-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL BEAUTY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-669-4141",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901013824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Wixom, MI
• Providers in Wixom, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.