Southgate Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SOUTHGATE FAMILY DENTAL

Practice address

15185 Allen Rd
Southgate, MI 48195-2921

Phone

(734) 324-2000

Fax

(734) 324-2092

NPI assigned

Jul 10, 2020

Organization subpart

No

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

Authorized official

Name

Lisa Chamberlain

Title

Office Manager

Phone

(734) 324-2000

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rodolfo Diaz, D.D.S., M.S.

  • Dentist
  • Farmington, MI
  • NPI 1891951067
  NPD
• Charles Peter Zammit, D.D.S.

  • General Practice Dentistry
  • Southgate, MI
  • NPI 1073648101
  NPD (past)

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1124646781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15185 ALLEN RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952921",
            "telephone_number": "734-324-2000",
            "fax_number": "734-324-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15185 ALLEN RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952921",
            "telephone_number": "734-324-2000",
            "fax_number": "734-324-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHGATE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "CHAMBERLAIN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "734-324-2000"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southgate Allied Anesthesia PLLC
• Southgate Ardent PLLC
• Southgate CT, PLC
• Southgate Ear Nose & Throat Center PLLC
• Southgate Ear Nose and Throat PLLC
• Southgate Foot and Ankle Center PLLC
• Southgate Medical Center PLLC
• Southgate Medical Clinic PC
• Southgate Medical Group, PLLC
• Southgate Mi Opco LLC

• Dental Clinic/Center in Southgate, MI
• Providers in Southgate, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.