NPIMap

Organization Active NPI

Wyandotte Optical,P.C.

  • Eyewear Supplier
  • Wyandotte, MI
National Provider Identifier
1235312570
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
4901002491 Issued in MI
Legal business name
WYANDOTTE OPTICAL,P.C.
Practice address
3101 Biddle St
Wyandotte, MI 48192-5915
Phone
(734) 282-5030
NPI assigned
Dec 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Dr. Dan A Stein, O.D.
Title
Optometrist
Phone
(734) 282-5030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 4901002491 MI Primary

Addresses

Primary practice location

3101 Biddle St
Wyandotte, MI 48192-5915

Mailing address

3101 Biddle St
Wyandotte, MI 48192-5915
Phone (734) 282-5030

Other identifiers 1

IdentifierTypeStateIssuer
900H266940OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1235312570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 BIDDLE ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925915",
            "telephone_number": "734-282-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 BIDDLE ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925915",
            "telephone_number": "734-282-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOTTE OPTICAL,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "734-282-5030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MI",
            "license": "4901002491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "900H266940",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.

Verify at the official NPI Registry.