Dakota Family Practice PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301091123 Issued in MI

Legal business name

DAKOTA FAMILY PRACTICE PLC

Practice address

1785 W Stadium Blvd
Ann Arbor, MI 48103-5285

Phone

(517) 917-3007

NPI assigned

Aug 2, 2010

Last updated

Jul 26, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ali M Khan, MD

Title

Owner

Phone

(517) 917-3007

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1184938268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 CHRISTY WAY",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032267",
            "telephone_number": "989-791-2455",
            "fax_number": "989-791-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 W STADIUM BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035285",
            "telephone_number": "517-917-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA FAMILY PRACTICE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-917-3007",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301091123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184938268",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Heather E Dakki, MSW
• Youssef Daklallah
• Dakota Laser Vision, PLLC
• Gregory W Dalack, MD
• Prarthana Dalal
• Damon Dale-Green
• Esther Dale

• Family Medicine Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.