Organization Active NPI

Medical Aesthetic Center PLC

  • Family Medicine Physician
  • Dearborn, MI
National Provider Identifier
1336817915
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL AESTHETIC CENTER PLC
Practice address
12740 W Warren Ave
Dearborn, MI 48126-4530
Phone
(248) 882-6966
NPI assigned
Aug 31, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Authorized official

Name
Bashar YalldoNPI 1891133575
Title
Owner
Phone
(248) 882-6966

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

12740 W Warren Ave
Dearborn, MI 48126-4530

Mailing address

12740 W Warren Ave
Dearborn, MI 48126-4530

National Provider Directory

National Provider Directory

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": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1336817915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12740 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12740 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264530",
            "telephone_number": "248-882-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL AESTHETIC CENTER PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "YALLDO",
        "authorized_official_first_name": "BASHAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-882-6966"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.