NPIMap

Organization Active NPI

Plymouth Endodontics

  • Endodontics
  • Plymouth, MI
National Provider Identifier
1285252874
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
PLYMOUTH ENDODONTICS
Doing business as
Plymouth Endodontics
Practice address
9416 S Main St Ste 212
Plymouth, MI 48170-4148
Phone
(734) 459-8844
NPI assigned
Jul 9, 2020
Last updated
Jul 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Steve J. Vlahakis, DDSNPI 1356469787
Title
Owner
Phone
(734) 459-8844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X Primary

Addresses

Primary practice location

9416 S Main St Ste 212
Plymouth, MI 48170-4148

Mailing address

9416 S Main St Ste 212
Plymouth, MI 48170-4148
Phone (734) 459-8844

Other identifiers 2

IdentifierTypeStateIssuer
160911863MedicaidMI
1356469787MedicaidMI

Other names 1

  • Plymouth Endodontics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Plymouth

National Provider Directory

National Provider Directory

Locations

9416 S Main St
Ste 212
Plymouth, MI 48170
Phone (734) 459-8844

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1285252874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9416 S MAIN ST STE 212",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704148",
            "telephone_number": "734-459-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9416 S MAIN ST STE 212",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704148",
            "telephone_number": "734-459-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "VLAHAKIS",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-459-8844",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160911863",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356469787",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Plymouth",
            "affiliation": "N",
            "address_1": "9416 S Main St Ste 212",
            "city": "Plymouth",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481704148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Plymouth Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.