Shelby Dental Center P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

1823026 Issued in MI

Legal business name

SHELBY DENTAL CENTER P.C.

Practice address

47059 Van Dyke Ave
Shelby TWP, MI 48317-3357

Phone

(586) 737-2778

Fax

(586) 737-2776

NPI assigned

Jan 13, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Wafid W Kizy, DMD

Title

Dentist

Phone

(248) 968-2748

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1154626687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47059 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173357",
            "telephone_number": "586-737-2778",
            "fax_number": "586-737-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47059 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173357",
            "telephone_number": "586-737-2778",
            "fax_number": "586-737-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY DENTAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "KIZY",
        "authorized_official_first_name": "WAFID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "248-968-2748",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "1823026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas L Schultz, MPT ATC
• Lynn Marie Schultz, PT
• Kurt Matthew Schulz, OD
• Kruti Sharma
• Katelyn Marie Shaw
• Shelby Urgent Care PC
• Shelby Urgent Care PC
• Shelby Urgent Care Walk-in Clinic
• Shelbydale Medical Clinic, P.C.
• Jason P Sheppard, LMSW- CLINICAL

• Dental Clinic/Center in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.