Organization Active NPI

American Dental Group Inc

  • Dentist
  • Bloomfield Hills, MI
National Provider Identifier
1215073010
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
AMERICAN DENTAL GROUP INC
Practice address
300 E Long Lake Rd
Ste 311
Bloomfield Hills, MI 48304
Phone
(248) 203-1100
Fax
(248) 203-1112
NPI assigned
Jan 29, 2007
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
Richard E Beckman
Title
Ceo
Phone
(248) 203-1121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

300 E Long Lake Rd
Ste 311
Bloomfield Hills, MI 48304

Mailing address

300 E Long Lake Rd
Ste 311
Bloomfield Hills, MI 48304
Phone (248) 203-1100

Other names 1

  • Great Expression Dental Centers Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215073010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E LONG LAKE RD",
            "address_2": "STE 311",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48304",
            "telephone_number": "248-203-1100",
            "fax_number": "248-203-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E LONG LAKE RD",
            "address_2": "STE 311",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48304",
            "telephone_number": "248-203-1100",
            "fax_number": "248-203-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DENTAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BECKMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-203-1121"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Expression Dental Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield Hills, 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.