Eliane Margarita Ortiz Puche, DDS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

2951000979 Issued in MI

Practice address

4201 Saint Antoine St Ste 2F
Detroit, MI 48201-2153

Phone

(313) 745-7071

NPI assigned

Jun 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1717200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1104667575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E 4TH ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672975",
            "telephone_number": "310-569-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST STE 2F",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ PUCHE",
        "first_name": "ELIANE",
        "middle_name": "MARGARITA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-01",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "2951000979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiesha Orr
• Trinity Orr
• Caitlyn Nicole Ortega, MD
• Tressa Lynne Orthmeyer, M.S., C.G.C.
• Orthopedic Trauma Specialist PLLC
• Aimee Amaris Ortiz, MSW
• Osama Nunu MD PLLC
• Osama Qaqi MD PLLC
• Emmanuella Iyore Osamuyi, MBBS
• Jabari Moyenda Osaze, RN

• Student in an Organized Health Care Education/Training Program in Detroit, MI
• Providers in Detroit, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.