NPIMap

Organization Active NPI

Professional Dental Alliance of Michigan, LLC

  • Dentist
  • Richmond, MI
National Provider Identifier
1144579467
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN, LLC
Practice address
69089 N Main St
Richmond, MI 48062-1146
Phone
(586) 727-5898
NPI assigned
Aug 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Authorized official

Name
Shams Hamama
Title
Office Manager
Phone
(586) 727-5898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

69089 N Main St
Richmond, MI 48062-1146

Mailing address

11 S Mill St
Ste 200
New Castle, PA 16101-3613
Phone (724) 698-2500

Other names 1

  • Dental Care of Michigan, Richmond Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Professional Dental Alliance of Michigan LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1144579467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST",
            "address_2": "STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013613",
            "telephone_number": "724-698-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69089 N MAIN ST",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480621146",
            "telephone_number": "586-727-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-31",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "HAMAMA",
        "authorized_official_first_name": "SHAMS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-727-5898"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Michigan, Richmond",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.