Deluxe Dental Associates #12- Shelby, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DELUXE DENTAL ASSOCIATES #12- SHELBY, PLLC

Doing business as

Deluxe Dental

Practice address

56625 Van Dyke Ave
Shelby Township, MI 48316-5025

Phone

(586) 248-4500

Fax

(810) 243-0454

NPI assigned

Oct 17, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Kristi Lynn Looney

Title

Biller/Credentialer

Phone

(810) 787-6332

Specialties & licenses 1

Addresses

Other names 1

• Deluxe Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sora Ibrahem Obead, DDS

  • General Practice Dentistry
  • Shelby Township, MI
  • NPI 1437891579
  NPD

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1245051770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56625 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165025",
            "telephone_number": "586-248-4500",
            "fax_number": "810-243-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56625 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165025",
            "telephone_number": "586-248-4500",
            "fax_number": "810-243-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELUXE DENTAL ASSOCIATES #12- SHELBY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "LOONEY",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLER/CREDENTIALER",
        "authorized_official_telephone_number": "810-787-6332",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deluxe Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachael Deblouw, RPH
• Bhumika Dedhia
• Molly Delfine, MA, LPC
• Manuela Della-Torre, AGNP
• Patricia Deloof, M.D.
• Deluxe Dental PLLC # 3
• Kimberly Denny, PA-C
• Brian Robert Derderian
• Denise Michelle Des Madryl, OTR
• Developing Connections, Inc.

• Dental Clinic/Center in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.