Organization Active NPI

Robert G. Nakisher, D.D.S., P.L.L.C

  • General Practice Dentistry
  • West Bloomfield, MI
National Provider Identifier
1104240415
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16085 Issued in MI
Legal business name
ROBERT G. NAKISHER, D.D.S., P.L.L.C
Practice address
7010 Pontiac TRL
West Bloomfield, MI 48323-2017
Phone
(248) 363-3304
Fax
(248) 363-0814
NPI assigned
Feb 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Authorized official

Name
Dr. Robert G Nakisher, D.D.S.
Title
Owner
Phone
(248) 363-3304

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 16085 MI Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 9918 MI
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 15650 MI
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 19162 MI

Addresses

Primary practice location

7010 Pontiac TRL
West Bloomfield, MI 48323-2017

Mailing address

7010 Pontiac TRL
West Bloomfield, MI 48323-2017
Phone (248) 363-3304

Other names 1

  • LakeView Family Dental Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391644800000",
    "number": "1104240415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7010 PONTIAC TRL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232017",
            "telephone_number": "248-363-3304",
            "fax_number": "248-363-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7010 PONTIAC TRL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232017",
            "telephone_number": "248-363-3304",
            "fax_number": "248-363-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G. NAKISHER, D.D.S., P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-06",
        "last_updated": "2014-02-06",
        "status": "A",
        "authorized_official_last_name": "NAKISHER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-363-3304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16085",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "9918",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "15650",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "19162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LakeView Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.