A1 Family Dentistry of Licoln Park,PLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901019199 Issued in MI

Legal business name

A1 FAMILY DENTISTRY OF LICOLN PARK,PLC

Practice address

3830 Fort St
Lincoln Park, MI 48146-4107

Phone

(586) 226-0638

NPI assigned

Jul 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Aneel Kaurr Randhawa, DDS

Title

Owner

Phone

(586) 226-0638

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1366826182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50481 KOSS DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480446320",
            "telephone_number": "586-226-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481464107",
            "telephone_number": "586-226-0638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A1 FAMILY DENTISTRY OF LICOLN PARK,PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "RANDHAWA",
        "authorized_official_first_name": "ANEEL",
        "authorized_official_middle_name": "KAURR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-226-0638",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.