NPIMap

Organization Active NPI

Grosse Pointe Family Dentistry

  • Dentist
  • Grosse Pointe Farms, MI
National Provider Identifier
1407388416
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13571 Issued in MI
Legal business name
GROSSE POINTE FAMILY DENTISTRY
Practice address
18501 Mack Ave
Grosse Pointe Farms, MI 48236-3224
Phone
(313) 882-9729
NPI assigned
Mar 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Authorized official

Name
Chris Panagos, DDSNPI 1578592762
Title
Owner
Phone
(313) 882-9729

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 13571 MI Primary

Addresses

Primary practice location

18501 Mack Ave
Grosse Pointe Farms, MI 48236-3224

Mailing address

18501 Mack Ave
Grosse Pointe Farms, MI 48236-3224
Phone (313) 882-9729

National Provider Directory

National Provider Directory

Locations

18501 Mack Ave
Grosse Pointe Farms, MI 48236
Phone (313) 820-5730

Practitioners & affiliated clinicians

Practitioners 3

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": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1407388416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18501 MACK AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363224",
            "telephone_number": "313-882-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18501 MACK AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363224",
            "telephone_number": "313-882-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSE POINTE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "PANAGOS",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-882-9729",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "13571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.