NPIMap

Organization Active NPI

D2 Dental of Michigan, P.C.

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1073045985
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
D2 DENTAL OF MICHIGAN, P.C.
Practice address
21427 Grand River Ave
Suite 100
Detroit, MI 48219-3896
Phone
(586) 393-5686
NPI assigned
Mar 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Authorized official

Name
Boris Labinov
Title
Agent
Phone
(708) 613-4542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

21427 Grand River Ave
Suite 100
Detroit, MI 48219-3896

Mailing address

137 N Oak Park Ave
Suite 310
Oak Park, IL 60301-1344

National Provider Directory

National Provider Directory
Tax ID family
D2 Dental of Michigan PC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

21427 Grand River Ave
Ste 100
Detroit, MI 48219
Phone (313) 412-2100

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1073045985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE",
            "address_2": "SUITE 310",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21427 GRAND RIVER AVE",
            "address_2": "SUITE 100",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193896",
            "telephone_number": "586-393-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D2 DENTAL OF MICHIGAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "LABINOV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "708-613-4542"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 30, 2017; 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.