Olde Orchard Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2901011539 Issued in MI

Legal business name

OLDE ORCHARD PEDIATRIC DENTISTRY

Doing business as

Susan H. Carron, D.D.S., M.S.

Practice address

40105 Grand River Ave Ste 2
Novi, MI 48375-2170

Phone

(248) 478-3232

NPI assigned

Sep 30, 2008

Last updated

Sep 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daphne West

Title

Assistant Office Manager

Phone

(248) 478-3232

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Susan H. Carron, D.D.S., M.S. 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, and the practitioner matching its NPPES authorized official.

• Susan Helen Carron, D.D.S., M.S.

  • Pediatric Dentistry
  • Novi, MI
  • NPI 1841245495
  NPD (past)

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1265682900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40105 GRAND RIVER AVE STE 2",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752170",
            "telephone_number": "248-478-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40105 GRAND RIVER AVE STE 2",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752170",
            "telephone_number": "248-478-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLDE ORCHARD PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "248-478-3232"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901011539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2669122",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2823071",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susan H. Carron, D.D.S., M.S.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ezinwanne Okorafor
• Christopher Okoye
• Amarachukwu Okwubanego
• Kimberlee Okwudibonye
• Jeneka Olawale
• Kaitlyn Oldenburg
• Stella Iroweimhe Oleita
• Sidney Olejniczak
• Sadie Oley
• Karen Olinik

• Pediatric Dentistry in Novi, MI
• Providers in Novi, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.