Elitedent PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ELITEDENT PLLC

Doing business as

Brookstone Dental

Practice address

13610 24 Mile Rd
Shelby TWP, MI 48315-2400

Phone

(586) 731-3131

NPI assigned

May 6, 2024

Organization subpart

No

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

Authorized official

Name

Linda Ousachi, DDS

Title

DDS

Phone

(586) 731-3131

Specialties & licenses 1

Addresses

Other names 1

• Brookstone Dental Doing business as

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1184471146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13610 24 MILE RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483152400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13610 24 MILE RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483152400",
            "telephone_number": "586-731-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITEDENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "OUSACHI",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "586-731-3131",
        "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": [
        {
            "organization_name": "Brookstone Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.