Active NPI
Kimberly Ann Danta-Dahl
- General Practice Dentistry
- Clinton TWP, MI
National Provider Identifier
1235302233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901015949
- Practice address
- 42550 Garfield Rd
Ste 104B
Clinton TWP, MI 48038-1644 - Phone
- (586) 228-2800
- NPI assigned
- Apr 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901015949 | MI | Primary |
Addresses
Primary practice location
42550 Garfield Rd
Ste 104B
Clinton TWP, MI 48038-1644
Mailing address
42550 Garfield Rd
Ste 104B
Clinton TWP, MI 48038-1644
Phone (586) 228-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901015949 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207785600000",
"number": "1235302233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42550 GARFIELD RD",
"address_2": "STE 104B",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480381644",
"telephone_number": "586-228-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42550 GARFIELD RD",
"address_2": "STE 104B",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480381644",
"telephone_number": "586-228-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANTA-DAHL",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-10",
"last_updated": "2008-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901015949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.