Active NPI
Childrens Dental Care of Detroit
- Pediatric Dentistry
- Detroit, MI
National Provider Identifier
1104482439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- CHILDRENS DENTAL CARE OF DETROIT
- Practice address
- 430 Mack Ave
Detroit, MI 48201-2136 - Phone
- (313) 262-6059
- Fax
- (313) 262-6331
- NPI assigned
- May 13, 2019
- 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
- Hassan Oueis, DDS
- Title
- Owner
- Phone
- (313) 262-6059
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | Primary |
Addresses
Primary practice location
430 Mack Ave
Detroit, MI 48201-2136
Mailing address
430 Mack Ave
Detroit, MI 48201-2136
Phone (313) 262-6059
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386813244 | Medicaid | MI |
Other names 1
- Children's Dental Care of Detroit
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Dentistry
- Dearborn, MI
- NPI 1386813244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1609804800000",
"number": "1104482439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 MACK AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012136",
"telephone_number": "313-262-6059",
"fax_number": "313-262-6331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 MACK AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012136",
"telephone_number": "313-262-6059",
"fax_number": "313-262-6331"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILDRENS DENTAL CARE OF DETROIT",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-13",
"last_updated": "2021-01-05",
"certification_date": "2021-01-05",
"status": "A",
"authorized_official_last_name": "OUEIS",
"authorized_official_first_name": "HASSAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "313-262-6059",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1386813244",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Children's Dental Care of Detroit",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Children's Dental Care of Detroit",
"code": "4",
"type": "Former Legal Business Name"
}
]
}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 Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.