NPIMap

Organization Active NPI

Universal Dental Group P.L.L.C.

Doing business as Universal Dental Center

  • Dentist
  • Warren, MI
National Provider Identifier
1114041266
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
015034 Issued in MI
Legal business name
UNIVERSAL DENTAL GROUP P.L.L.C.
Doing business as
Universal Dental Center
Practice address
28478 Dequindre Rd
Warren, MI 48092-5605
Phone
(586) 574-2620
Fax
(586) 574-3015
NPI assigned
Mar 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ronald S. Goodman, DDSNPI 1023096047
Title
Dentist
Phone
(586) 574-2620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 015034 MI Primary

Addresses

Primary practice location

28478 Dequindre Rd
Warren, MI 48092-5605

Mailing address

28478 Dequindre
Warren, MI 48092-5605
Phone (586) 574-2620

Other names 1

  • Universal Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

28478 Dequindre
Warren, MI 48092

28478 Dequindre Rd
Warren, MI 48092
Phone (586) 574-2620

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114041266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28478 DEQUINDRE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925605",
            "telephone_number": "586-574-2620",
            "fax_number": "586-574-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28478 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925605",
            "telephone_number": "586-574-2620",
            "fax_number": "586-574-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL DENTAL GROUP P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "586-574-2620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "015034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Universal Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.