Supreme Dental Care, PLC

Primary specialty

DentistTaxonomy code 122300000X

License

2901019596 Issued in MI

Legal business name

SUPREME DENTAL CARE, PLC

Practice address

25150 Ford Rd
Suite 220
Dearborn Heights, MI 48127-3115

Phone

(313) 908-1430

Fax

(313) 406-5068

NPI assigned

Jan 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Amal A Aoun, DDS

Title

Owner

Phone

(313) 908-1430

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1388707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1144641572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25150 FORD RD",
            "address_2": "SUITE 220",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273115",
            "telephone_number": "313-908-1430",
            "fax_number": "313-406-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25150 FORD RD",
            "address_2": "SUITE 220",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273115",
            "telephone_number": "313-908-1430",
            "fax_number": "313-406-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME DENTAL CARE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-03",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "AOUN",
        "authorized_official_first_name": "AMAL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-908-1430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.