Tender Dental Care PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15924 Issued in MI

Legal business name

TENDER DENTAL CARE PC

Practice address

1024 N Genesee
Burton, MI 48509

Phone

(810) 715-3368

Fax

(810) 715-1663

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Authorized official

Name

Prabha R Raju, DDSNPI 1710150925

Title

Owner Doctor

Phone

(810) 715-3368

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prabha R Raju, D.D.S.

  • General Practice Dentistry
  • Burton, MI
  • NPI 1710150925
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073689899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90161",
            "address_2": "1024 N GENESEE",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "48509",
            "telephone_number": "810-715-3368",
            "fax_number": "810-715-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 N GENESEE",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "48509",
            "telephone_number": "810-715-3368",
            "fax_number": "810-715-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDER DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAJU",
        "authorized_official_first_name": "PRABHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "810-715-3368",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "15924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandrea Taylor
• Damascus Malik J Shan Taylor
• Jeffery Mark Taylor II
• Shariya Taylor
• Tender Dental Care
• Rose Anna-Theresa Tester
• The Pediatric Place PC
• Lorelei Thoman
• Brianna Kadaysha Thomas-Hayes
• Charlette Loring Thomas

• General Practice Dentistry in Burton, MI
• Providers in Burton, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.