Organization Active NPI

Dima G Khalife DDS PC

  • Dental Clinic/Center
  • Clinton Township, MI
National Provider Identifier
1255040309
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DIMA G KHALIFE DDS PC
Practice address
41570 Hayes Rd
Clinton Township, MI 48038-5867
Phone
(586) 226-2700
Fax
(586) 226-4320
NPI assigned
Nov 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Authorized official

Name
Chris Rettig
Title
Coordinator
Phone
(586) 226-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

41570 Hayes Rd
Clinton Township, MI 48038-5867

Mailing address

41570 Hayes Rd
Clinton Township, MI 48038-5867
Phone (586) 226-2700

Other identifiers 1

IdentifierTypeStateIssuer
1447495635MedicaidMI

National Provider Directory

National Provider Directory

Locations

41570 Hayes Rd
Clinton Twp, MI 48038
Phone (586) 263-3660

Practitioners & affiliated clinicians

Practitioners 1

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": "1668643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1255040309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41570 HAYES RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385867",
            "telephone_number": "586-226-2700",
            "fax_number": "586-226-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41570 HAYES RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385867",
            "telephone_number": "586-226-2700",
            "fax_number": "586-226-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMA G KHALIFE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "RETTIG",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "586-226-2700"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447495635",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.