Individual provider Active NPI

Donya Dabiri

  • Pediatric Dentistry
  • Grosse Pointe Woods, MI
National Provider Identifier
1285292490
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2901601008 Issued in MI
Practice address
19251 Mack Ave Ste 220
Grosse Pointe Woods, MI 48236-2881
Phone
(313) 343-8790
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2901601008 MI Primary

Addresses

Primary practice location

19251 Mack Ave Ste 220
Grosse Pointe Woods, MI 48236-2881

Mailing address

390 Meadow Creek Dr
Ann Arbor, MI 48105-3052
Phone (734) 486-5578

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190705001137 OH Order and Referring Only - DentistPractitioner - Dentist 1254666704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901601008MIMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Toothworks PC PastSince Aug 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1285292490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 MEADOW CREEK DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481053052",
            "telephone_number": "734-486-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19251 MACK AVE STE 220",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362881",
            "telephone_number": "313-343-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABIRI",
        "first_name": "DONYA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901601008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.