NPIMap

Organization Active NPI

Paul E Marcuz D.D.S.,P.C.

  • General Practice Dentistry
  • Eastpointe, MI
National Provider Identifier
1073790200
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
015934 Issued in MI
Legal business name
PAUL E MARCUZ D.D.S.,P.C.
Practice address
22770 Kelly Rd
Eastpointe, MI 48021-2009
Phone
(586) 775-0520
Fax
(586) 775-2670
NPI assigned
Jan 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Ms. Kim Marie Hirth
Title
Office Manager
Phone
(586) 775-0520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 015934 MI Primary

Addresses

Primary practice location

22770 Kelly Rd
Eastpointe, MI 48021-2009

Mailing address

22770 Kelly Rd
Eastpointe, MI 48021-2009
Phone (586) 775-0520

Other identifiers 3

IdentifierTypeStateIssuer
0002091OtherMIASSURANT
053109OtherMIFIRST COMMONWEALTH
3375692MedicaidMI

National Provider Directory

National Provider Directory

Locations

22770 Kelly Rd
Eastpointe, MI 48021
Phone (586) 775-0520

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1073790200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22770 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212009",
            "telephone_number": "586-775-0520",
            "fax_number": "586-775-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22770 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212009",
            "telephone_number": "586-775-0520",
            "fax_number": "586-775-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL E MARCUZ D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "HIRTH",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-775-0520",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "015934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSURANT",
            "identifier": "0002091",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST COMMONWEALTH",
            "identifier": "053109",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3375692",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.