NPIMap

Organization Active NPI

Endodontic Associates of Michigan PLLC

  • Endodontics
  • Waterford, MI
National Provider Identifier
1164479101
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
ENDODONTIC ASSOCIATES OF MICHIGAN PLLC
Practice address
2335 Pontiac Lake Rd
Ste. D
Waterford, MI 48328-2761
Phone
(248) 683-2300
NPI assigned
May 27, 2006
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Dr. Gerald C Dietz Jr., DDSNPI 1497795660
Title
Partner Doctor
Phone
(248) 647-7930

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X Primary

Addresses

Primary practice location

2335 Pontiac Lake Rd
Ste. D
Waterford, MI 48328-2761

Mailing address

2335 Pontiac Lake Rd
Ste. D
Waterford, MI 48328-2761
Phone (248) 683-2300

National Provider Directory

National Provider Directory
Tax ID family
Endodontic Associates9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

2335 Pontiac Lake Rd
Waterford, MI 48328
Phone (248) 681-3600

2335 Pontiac Lake Rd
Ste D
Waterford, MI 48328
Phone (248) 683-2300

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1164479101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 PONTIAC LAKE RD",
            "address_2": "STE. D",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282761",
            "telephone_number": "248-683-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 PONTIAC LAKE RD",
            "address_2": "STE. D",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282761",
            "telephone_number": "248-683-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC ASSOCIATES OF MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER DOCTOR",
        "authorized_official_telephone_number": "248-647-7930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 3, 2025; 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.