NPIMap

Organization Active NPI

Personalized Dentistry

  • General Practice Dentistry
  • Warren, MI
National Provider Identifier
1316071863
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8373 Issued in MI
Legal business name
PERSONALIZED DENTISTRY
Practice address
30825 Ryan Rd
Warren, MI 48092-1903
Phone
(586) 751-2900
Fax
(586) 751-5224
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Bernard Lewis, DDSNPI 1013025659
Title
President
Phone
(586) 751-2900

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
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 8373 MI Primary

Addresses

Primary practice location

30825 Ryan Rd
Warren, MI 48092-1903

Mailing address

30825 Ryan Rd
Warren, MI 48092-1903
Phone (586) 751-2900

Other identifiers 1

IdentifierTypeStateIssuer
4017310MedicaidMI

Other names 1

  • Lewis, Rochlen & Rochlen Other name

National Provider Directory

National Provider Directory

Locations

30825 Ryan Rd
Warren, MI 48092
Phone (586) 751-2900

Practitioners & affiliated clinicians

Practitioners 3

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316071863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30825 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921903",
            "telephone_number": "586-751-2900",
            "fax_number": "586-751-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30825 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921903",
            "telephone_number": "586-751-2900",
            "fax_number": "586-751-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-751-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "8373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4017310",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewis, Rochlen & Rochlen",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.