Deluxe Dental Associates 10- Waterford PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DELUXE DENTAL ASSOCIATES 10- WATERFORD PLLC

Doing business as

Deluxe Dental Associates

Practice address

1090 W Huron St
Waterford, MI 48328-3733

Phone

(810) 820-7766

Fax

(810) 243-0454

NPI assigned

Jul 17, 2024

Organization subpart

No

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

Authorized official

Name

Amber Mikha-Kizy, DDS

Title

Owner

Phone

(810) 820-7766

Specialties & licenses 1

Addresses

Other names 1

• Deluxe Dental Associates Doing business as

Locations

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1255179842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 S DORT HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072045",
            "telephone_number": "810-820-7766",
            "fax_number": "810-243-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W HURON ST",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283733",
            "telephone_number": "810-820-7766",
            "fax_number": "810-243-0454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELUXE DENTAL ASSOCIATES 10- WATERFORD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "MIKHA-KIZY",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-820-7766",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deluxe Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Degroff, LMSW
• James Raymond Delaney III, D.D.S.
• Keith I Delap, D.C.
• Dora Deller, MS, CCC
• Jennifer Delong
• Marguerite E. Demaria, OTR/L
• David Denova
• Avinash M Desai, MD
• Hemangini A Desai, MD
• Destination Medical Equipment LLC

• General Practice Dentistry in Waterford, MI
• Providers in Waterford, MI by specialty
• General Practice Dentistry in Michigan

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