Visiting Dental Associates P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

17336 Issued in MI

Legal business name

VISITING DENTAL ASSOCIATES P.C.

Practice address

20770 Kelly Rd
Suite B
Eastpointe, MI 48021-3114

Phone

(586) 779-3333

NPI assigned

Mar 30, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Reginald Bernard Jewell, DDS

Title

President

Phone

(313) 535-7770

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1306135413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20770 KELLY RD",
            "address_2": "SUITE B",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213114",
            "telephone_number": "586-779-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20770 KELLY RD",
            "address_2": "SUITE B",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213114",
            "telephone_number": "586-779-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISITING DENTAL ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "JEWELL",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-535-7770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "17336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Eastpointe, MI
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• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.