NPIMap

Organization Active NPI

Warren Laser Dentistry

  • General Practice Dentistry
  • Warren, MI
National Provider Identifier
1215219233
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WARREN LASER DENTISTRY
Practice address
4224 E 10 Mile Rd
Warren, MI 48091-1577
Phone
(586) 756-6351
Fax
(586) 756-6253
NPI assigned
Sep 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Haifa Mansour
Title
Dentist
Phone
(586) 756-6351

Specialties & licenses 1

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

Addresses

Primary practice location

4224 E 10 Mile Rd
Warren, MI 48091-1577

Mailing address

4224 E 10 Mile Rd
Warren, MI 48091-1577
Phone (586) 756-6351

National Provider Directory

National Provider Directory

Locations

4224 E 10 Mile Rd
Warren, MI 48091
Phone (586) 756-6351

Practitioners & affiliated clinicians

Practitioners 5

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": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1215219233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480911577",
            "telephone_number": "586-756-6351",
            "fax_number": "586-756-6253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480911577",
            "telephone_number": "586-756-6351",
            "fax_number": "586-756-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN LASER DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "HAIFA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "586-756-6351"
    },
    "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 Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.