Fifth Street Dental Care PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2901017984 Issued in MI

Legal business name

FIFTH STREET DENTAL CARE PLLC

Practice address

8048 5TH St
Dexter, MI 48130-1033

Phone

(734) 426-2220

Fax

(734) 426-4480

NPI assigned

Feb 12, 2015

Last updated

Feb 12, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Doni R Mallia, D.D.S.NPI 1306916879

Title

Dentist

Phone

(734) 426-2220

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Doni Rebecca Mallia, D.D.S.

  • General Practice Dentistry
  • Dexter, MI
  • NPI 1306916879
  Authorized official Same address or phone

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1356732309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8048 5TH ST",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301033",
            "telephone_number": "734-426-2220",
            "fax_number": "734-426-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8048 5TH ST",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301033",
            "telephone_number": "734-426-2220",
            "fax_number": "734-426-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTH STREET DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "MALLIA",
        "authorized_official_first_name": "DONI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "734-426-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "2901017984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Denise Eisele, MA, SLP
• Elevate Consulting & Wellness, LLC
• Katheryn Anne Elibri Frame, D.O.
• Empower Me Therapy, PLLC
• Stacey Fernandez, RD
• Fifth Street Dental, P.C.
• Hannah Marie Fleenary
• Martin Dwayne Fletcher, PSY.D
• Rose Follick
• Frederick Schmid Inc (Dexter Pharmacy 2)

• Dental Clinic/Center in Dexter, MI
• Providers in Dexter, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.