Organization Active NPI

Ypsilanti Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Ypsilanti, MI
National Provider Identifier
1164533204
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
YPSILANTI FAMILY & COSMETIC DENTISTRY
Practice address
124 Pearl St
Ste 207
Ypsilanti, MI 48197-2663
Phone
(734) 481-0180
Fax
(734) 481-1087
NPI assigned
Aug 31, 2006
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
Walter Eric Phillips, DDSNPI 1811954415
Title
Owner
Phone
(734) 481-0180

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: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

124 Pearl St
Ste 207
Ypsilanti, MI 48197-2663

Mailing address

124 Pearl St
Ste 207
Ypsilanti, MI 48197-2663
Phone (734) 481-0180

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164533204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 PEARL ST",
            "address_2": "STE 207",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972663",
            "telephone_number": "734-481-0180",
            "fax_number": "734-481-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 PEARL ST",
            "address_2": "STE 207",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972663",
            "telephone_number": "734-481-0180",
            "fax_number": "734-481-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YPSILANTI FAMILY & COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-481-0180",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, 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.