Active NPI
Fill Good Dental Center PLLC
- Dentist
- Detroit, MI
National Provider Identifier
1093266215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901017708
- Legal business name
- FILL GOOD DENTAL CENTER PLLC
- Practice address
- 18570 Grand River Ave
102
Detroit, MI 48223-2201 - Phone
- (313) 837-3000
- Fax
- (313) 838-4581
- NPI assigned
- Oct 24, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lawrence Stewart, D.D.S.
- Title
- Doc/Partner
- Phone
- (313) 837-3000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901017708 | MI | Primary |
Addresses
Primary practice location
18570 Grand River Ave
102
Detroit, MI 48223-2201
Mailing address
18750 Grand River Ave
102
Detroit, MI 48223
Phone (313) 837-3000
National Provider Directory
National Provider DirectoryLocations
18570 Grand River Ave
Ste 102
Detroit, MI 48223
Phone (313) 646-4681
18750 Grand Riv Ave
102
Detroit, MI 48223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477267200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1477267200000",
"number": "1093266215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18750 GRAND RIVER AVE",
"address_2": "102",
"city": "DETROIT",
"state": "MI",
"postal_code": "48223",
"telephone_number": "313-837-3000",
"fax_number": "313-838-4581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18570 GRAND RIVER AVE",
"address_2": "102",
"city": "DETROIT",
"state": "MI",
"postal_code": "482232201",
"telephone_number": "313-837-3000",
"fax_number": "313-838-4581"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FILL GOOD DENTAL CENTER PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-24",
"last_updated": "2016-10-24",
"status": "A",
"authorized_official_last_name": "STEWART",
"authorized_official_first_name": "LAWRENCE",
"authorized_official_title_or_position": "DOC/PARTNER",
"authorized_official_telephone_number": "313-837-3000",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MI",
"license": "2901017708",
"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 Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.