Individual provider Active NPI

Roman Mammo, DDS

  • General Practice Dentistry
  • Garden City, MI
National Provider Identifier
1336070952
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901603217 Issued in MI
Practice address
6755 Merriman Rd
Garden City, MI 48135-1978
Phone
(734) 680-0420
NPI assigned
May 25, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901603217 MI Primary

Addresses

Primary practice location

6755 Merriman Rd
Garden City, MI 48135-1978

Mailing address

7364 Essex Dr
West Bloomfield, MI 48322-1140
Phone (619) 818-2833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1779667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1336070952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7364 ESSEX DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221140",
            "telephone_number": "619-818-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6755 MERRIMAN RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351978",
            "telephone_number": "734-680-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMO",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-25",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901603217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.