NPIMap

Organization Active NPI

Gantz, D.D.S., P.L.L.C.

  • Dentist
  • Southfield, MI
National Provider Identifier
1356511950
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13299 Issued in MI
Legal business name
GANTZ, D.D.S., P.L.L.C.
Practice address
25865 W 12 Mile Rd
Suite D-112
Southfield, MI 48034-1817
Phone
(248) 353-4010
Fax
(248) 353-0829
NPI assigned
Mar 11, 2008
Last updated
Mar 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Dr. Elaine K Gantz, DDSNPI 1013996537
Title
Owner
Phone
(248) 353-4010

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 13299 MI Primary

Addresses

Primary practice location

25865 W 12 Mile Rd
Suite D-112
Southfield, MI 48034-1817

Mailing address

25865 W 12 Mile Rd
Suite D-112
Southfield, MI 48034-1817
Phone (248) 353-4010

Other identifiers 2

IdentifierTypeStateIssuer
1598979676OtherMINPI
1013996537OtherMINPI

Other names 1

  • elaine Gantz, D.D.S. Other name

National Provider Directory

National Provider Directory
Tax ID family
Elaine Gantz DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25865 W 12 Mile Rd
Ste D112
Southfield, MI 48034
Phone (248) 353-4010

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1356511950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD",
            "address_2": "SUITE D-112",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-353-4010",
            "fax_number": "248-353-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD",
            "address_2": "SUITE D-112",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-353-4010",
            "fax_number": "248-353-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GANTZ, D.D.S., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "GANTZ",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-353-4010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "13299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1598979676",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013996537",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "elaine Gantz, D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.