Organization Active NPI

Berman Family Dentistry PLLC

  • General Practice Dentistry
  • Plymouth, MI
National Provider Identifier
1336749522
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BERMAN FAMILY DENTISTRY PLLC
Practice address
9430 S Main St Ste 1
Plymouth, MI 48170-4149
Phone
(734) 453-2200
Fax
(734) 453-2318
NPI assigned
Oct 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Donna M Sadowski
Title
Office MGR
Phone
(734) 453-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

9430 S Main St Ste 1
Plymouth, MI 48170-4149

Mailing address

9430 S Main St Ste 1
Plymouth, MI 48170-4149
Phone (734) 453-2200

Other identifiers 2

IdentifierTypeStateIssuer
1003166729MedicaidMI
1114975638MedicaidMI

National Provider Directory

National Provider Directory

Locations

9430 S Main St
Ste 1
Plymouth, MI 48170
Phone (734) 453-2200

Practitioners & affiliated clinicians

Practitioners 1

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": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1336749522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 S MAIN ST STE 1",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704149",
            "telephone_number": "734-453-2200",
            "fax_number": "734-453-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 S MAIN ST STE 1",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704149",
            "telephone_number": "734-453-2200",
            "fax_number": "734-453-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERMAN FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "SADOWSKI",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "734-453-2200"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003166729",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114975638",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.