NPIMap

Organization Active NPI

Brightside Dental

  • General Practice Dentistry
  • Sterling Heights, MI
National Provider Identifier
1154538569
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11295 Issued in MI
Legal business name
BRIGHTSIDE DENTAL
Practice address
13750 19 Mile Rd
Sterling Heights, MI 48313-2702
Phone
(586) 247-0010
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Abraham GershonowiczNPI 1982808358
Title
Owner
Phone
(586) 247-0010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 11295 MI Primary

Addresses

Primary practice location

13750 19 Mile Rd
Sterling Heights, MI 48313-2702

Mailing address

13750 19 Mile Rd
Sterling Heights, MI 48313-2702
Phone (586) 247-0010

National Provider Directory

National Provider Directory

Locations

13750 19 Mile Rd
Sterling Heights, MI 48313
Phone (586) 229-1916

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154538569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13750 19 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483132702",
            "telephone_number": "586-247-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 19 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483132702",
            "telephone_number": "586-247-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTSIDE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERSHONOWICZ",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-247-0010",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.