NPIMap

Organization Active NPI

Dr. Pratiksha Agrawal Dental Services PC

  • General Practice Dentistry
  • Bloolfield Hills, MI
National Provider Identifier
1174075816
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DR. PRATIKSHA AGRAWAL DENTAL SERVICES PC
Practice address
2550 Telegraph Road
Suite 104
Bloolfield Hills, MI 48302
Phone
(248) 292-0188
NPI assigned
Oct 28, 2016
Last updated
Oct 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Pratiksha AgrawalNPI 1568909943
Title
Associate Dentist
Phone
(312) 208-5566

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary
ProsthodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0700X

Addresses

Primary practice location

2550 Telegraph Road
Suite 104
Bloolfield Hills, MI 48302

Mailing address

1468 Devon Lane
Troy, MI 48084
Phone (312) 208-5566

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1477612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1174075816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 DEVON LANE",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48084",
            "telephone_number": "312-208-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 TELEGRAPH ROAD",
            "address_2": "SUITE 104",
            "city": "BLOOLFIELD HILLS",
            "state": "MI",
            "postal_code": "48302",
            "telephone_number": "248-292-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PRATIKSHA AGRAWAL DENTAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "AGRAWAL",
        "authorized_official_first_name": "PRATIKSHA",
        "authorized_official_title_or_position": "ASSOCIATE DENTIST",
        "authorized_official_telephone_number": "312-208-5566"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.