NPIMap

Organization Active NPI

Modern American Dental Clinic P. C.

  • Dentist
  • Dearborn, MI
National Provider Identifier
1407184641
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
015159 MI Issued in MI
Legal business name
MODERN AMERICAN DENTAL CLINIC P. C.
Practice address
14350 W Warren Ave
Dearborn, MI 48126-1459
Phone
(313) 582-1919
NPI assigned
Nov 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Authorized official

Name
Dr. Nabil Berry, DDSNPI 1255413670
Title
President
Phone
(313) 582-1919

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: 193400000X SINGLE SPECIALTY GROUP 122300000X 015159 MI MI Primary

Addresses

Primary practice location

14350 W Warren Ave
Dearborn, MI 48126-1459

Mailing address

14350 W Warren Ave
Dearborn, MI 48126-1459
Phone (313) 582-1919

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": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1407184641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14350 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261459",
            "telephone_number": "313-582-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14350 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261459",
            "telephone_number": "313-582-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN AMERICAN DENTAL CLINIC P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "NABIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-582-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "015159 MI",
            "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 Nov 30, 2009; 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.