Organization Active NPI

Comprehensive Dental, PC

  • Dentist
  • Detroit, MI
National Provider Identifier
1134582802
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021770 Issued in MI
Legal business name
COMPREHENSIVE DENTAL, PC
Practice address
15510 Livernois Ave
Detroit, MI 48238-1343
Phone
(313) 863-2800
NPI assigned
Mar 31, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Authorized official

Name
Donna Marie Kirchner
Title
Credentialing Manager
Phone
(586) 915-0107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901021770 MI Primary

Addresses

Primary practice location

15510 Livernois Ave
Detroit, MI 48238-1343

Mailing address

15510 Livernois Ave
Detroit, MI 48238-1343
Phone (313) 863-2800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1134582802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15510 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381343",
            "telephone_number": "313-863-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15510 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381343",
            "telephone_number": "313-863-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "KIRCHNER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "586-915-0107"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021770",
            "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 Mar 31, 2016; 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.