Organization Active NPI

Convenient St, PC

Doing business as Convenient Dental Care

  • General Practice Dentistry
  • Shelby TWP, MI
National Provider Identifier
1407020670
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CONVENIENT ST, PC
Doing business as
Convenient Dental Care
Practice address
52131 Van Dyke Ave
Shelby TWP, MI 48316-3529
Phone
(586) 739-6363
Fax
(586) 739-6473
NPI assigned
Apr 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Authorized official

Name
Ms. Marilyn Moskaitis
Title
Office Manager
Phone
(248) 723-1450

Specialties & licenses 1

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

Addresses

Primary practice location

52131 Van Dyke Ave
Shelby TWP, MI 48316-3529

Mailing address

52131 Van Dyke Ave
Shelby TWP, MI 48316-3529
Phone (586) 739-6363

Other names 1

  • Convenient Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

52131 Van Dyke Ave
Shelby Township, MI 48316
Phone (586) 739-6363

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1407020670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52131 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483163529",
            "telephone_number": "586-739-6363",
            "fax_number": "586-739-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52131 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483163529",
            "telephone_number": "586-739-6363",
            "fax_number": "586-739-6473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT ST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "MOSKAITIS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-723-1450",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Convenient Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelby TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.