J Y Dental DMD PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

J Y DENTAL DMD PLLC

Doing business as

Metro Dental Specialists

Practice address

13874 Grand River Ave
Detroit, MI 48227-3123

Phone

(313) 834-4900

NPI assigned

Nov 22, 2024

Organization subpart

No

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

Authorized official

Name

Alex Wolicki

Title

Accountant

Phone

(586) 558-8004

Specialties & licenses 1

Addresses

Other names 1

• Metro Dental Specialists Doing business as

Locations

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1104641208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27201 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13874 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482273123",
            "telephone_number": "313-834-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J Y DENTAL DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "WOLICKI",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "586-558-8004"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Dental Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Detroit, MI
• Providers in Detroit, 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 Nov 22, 2024; 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.