Individual provider Active NPI

Brittany Swiderski

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Detroit, MI
National Provider Identifier
1114453214
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
060587 Issued in NY
Practice address
2700 Martin Luther King Jr Blvd
University of Detroit Mercy School of Dentistry
Detroit, MI 48208
Phone
(313) 494-6606
NPI assigned
May 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901022369 MI
Student in an Organized Health Care Education/Training Program 390200000X
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 060587 NY Primary

Addresses

Primary practice location

2700 Martin Luther King Jr Blvd
University of Detroit Mercy School of Dentistry
Detroit, MI 48208

Mailing address

2700 Martin Luther King Jr Blvd
University of Detroit Mercy School of Dentistry
Detroit, MI 48208-2576
Phone (313) 494-6606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901022369MIMDDentist
060587NYMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1114453214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "address_2": "UNIVERSITY OF DETROIT MERCY SCHOOL OF DENTISTRY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "address_2": "UNIVERSITY OF DETROIT MERCY SCHOOL OF DENTISTRY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48208",
            "telephone_number": "313-494-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIDERSKI",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022369",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "060587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 4, 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.