Organization Active NPI

Prime Dentistry Novi PLLC

  • Dental Clinic/Center
  • Dearborn, MI
National Provider Identifier
1124706775
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PRIME DENTISTRY NOVI PLLC
Practice address
24505 Fairmount Dr
Dearborn, MI 48124-1541
Phone
(734) 722-1617
NPI assigned
Jul 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Jessica Tomes
Title
Operations Director
Phone
(734) 722-1617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

24505 Fairmount Dr
Dearborn, MI 48124-1541

Mailing address

35100 E Michigan Ave
Wayne, MI 48184-3698
Phone (734) 722-1617

National Provider Directory

National Provider Directory

Locations

35100 E Michigan Ave
Wayne, MI 48184
Phone (586) 651-2155

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1124706775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35100 E MICHIGAN AVE",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481843698",
            "telephone_number": "734-722-1617",
            "fax_number": "734-722-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24505 FAIRMOUNT DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241541",
            "telephone_number": "734-722-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME DENTISTRY NOVI PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "TOMES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "734-722-1617"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.