NPIMap

Organization Active NPI

Seva Dental Michigan PC

  • Dentist
  • Waterford, MI
National Provider Identifier
1144088014
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SEVA DENTAL MICHIGAN PC
Practice address
4025 Highland Rd
Waterford, MI 48328-2134
Phone
(248) 831-1865
NPI assigned
Mar 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Kelly Rolnicki
Title
Director of Revenue Cycle
Phone
(708) 372-4773

Specialties & licenses 1

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

Addresses

Primary practice location

4025 Highland Rd
Waterford, MI 48328-2134

Mailing address

19518 Lancaster Dr
Mokena, IL 60448-7838
Phone (708) 372-4773

Other names 1

  • Waterford Dental Team Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Seva Dental Michigan PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1144088014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19518 LANCASTER DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604487838",
            "telephone_number": "708-372-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282134",
            "telephone_number": "248-831-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEVA DENTAL MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "ROLNICKI",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "708-372-4773"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterford Dental Team",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.