Michigan Implant Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MICHIGAN IMPLANT DENTAL CENTER

Practice address

28701 Plymouth Rd Ste B
Livonia, MI 48150-2421

Phone

(734) 427-9300

NPI assigned

Sep 11, 2020

Organization subpart

No

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

Authorized official

Name

Abdul ShakfaNPI 1114066586

Title

General

Phone

(734) 427-9300

Specialties & licenses 1

Addresses

Other names 1

• Livonia Cosmetic Dental Former legal business name

Locations

Practitioners 1

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

• Abdul Shakfa, DDS

  • General Practice Dentistry
  • Charlotte, MI
  • NPI 1114066586
  NPD Authorized official

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1265047641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28701 PLYMOUTH RD STE B",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502421",
            "telephone_number": "734-427-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28701 PLYMOUTH RD STE B",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502421",
            "telephone_number": "734-427-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN IMPLANT DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "SHAKFA",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "GENERAL",
        "authorized_official_telephone_number": "734-427-9300"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livonia Cosmetic Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• General Practice Dentistry in Livonia, MI
• Providers in Livonia, 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 Sep 11, 2020; 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.