Active NPI
Dynamic Life, PLLC
- Chiropractor
- Royal Oak, MI
National Provider Identifier
1225349798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301009205
- Legal business name
- DYNAMIC LIFE, PLLC
- Doing business as
- Dynamic Life Chiropractic
- Practice address
- 3400 Rochester Rd
Royal Oak, MI 48073-2813 - Phone
- (248) 593-0843
- Fax
- (248) 593-3069
- NPI assigned
- Jun 29, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Daniel J Judge, DC
- Title
- President
- Phone
- (248) 885-3866
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301009205 | MI | Primary |
Addresses
Primary practice location
3400 Rochester Rd
Royal Oak, MI 48073-2813
Mailing address
3400 Rochester Rd
Royal Oak, MI 48073-2813
Phone (248) 593-0843
Other names 1
- Dynamic Life Chiropractic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3400 Rochester Rd
Royal Oak, MI 48073
Phone (248) 593-0843
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Birmingham, MI
- NPI 1003828047
-
- Chiropractor
- Birmingham, MI
- NPI 1205476330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277769600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696896000000",
"number": "1225349798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 ROCHESTER RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480732813",
"telephone_number": "248-593-0843",
"fax_number": "248-593-3069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 ROCHESTER RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480732813",
"telephone_number": "248-593-0843",
"fax_number": "248-593-3069"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNAMIC LIFE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-06-29",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A",
"authorized_official_last_name": "JUDGE",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "248-885-3866",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "MI",
"license": "2301009205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Dynamic Life Chiropractic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Dynamic Life Chiropractic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.