NPIMap

Organization Active NPI

Ann Arbor Dental Specialists

  • Pediatric Dentistry
  • Ann Arbor, MI
National Provider Identifier
1306014816
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2901010113 Issued in MI
Legal business name
ANN ARBOR DENTAL SPECIALISTS
Practice address
3100 E Eisenhower Pkwy
Suite 200
Ann Arbor, MI 48108-5205
Phone
(734) 971-3368
Fax
(734) 971-3979
NPI assigned
Feb 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Dr. James W Clark, D.D.S., M.S.NPI 1770501793
Title
Dentist
Phone
(734) 971-3368

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 2901010113 MI Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 2901018096 MI

Addresses

Primary practice location

3100 E Eisenhower Pkwy
Suite 200
Ann Arbor, MI 48108-5205

Mailing address

3100 E Eisenhower Pkwy
Suite 200
Ann Arbor, MI 48108-5205
Phone (734) 971-3368

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1306014816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E EISENHOWER PKWY",
            "address_2": "SUITE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085205",
            "telephone_number": "734-971-3368",
            "fax_number": "734-971-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E EISENHOWER PKWY",
            "address_2": "SUITE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085205",
            "telephone_number": "734-971-3368",
            "fax_number": "734-971-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN ARBOR DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "734-971-3368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901010113",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901018096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.