Office 5 PLLC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

OFFICE 5 PLLC

Practice address

201 S Lafayette St
South Lyon, MI 48178-1405

Phone

(248) 437-4119

NPI assigned

Nov 25, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Randall Loren Shaw, DDS, MSNPI 1891942165

Title

Owner

Phone

(248) 931-1151

Specialties & licenses 1

Addresses

Other names 1

• South Lyon Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randall Loren Shaw, D.D.S.,M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Southfield, MI
  • NPI 1891942165

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1407450877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PINE RIDGE DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042139",
            "telephone_number": "248-931-1151",
            "fax_number": "248-594-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S LAFAYETTE ST",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781405",
            "telephone_number": "248-437-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OFFICE 5 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "LOREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-931-1151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Lyon Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Nidetz, LMSW
• Matthew Alan Niemiec, MPT
• Raymond Nkrumah
• Ronald Nomura, LMT, BCTMB, CPMT
• Novian Care LLC
• Susan Okonkowski, RD
• Oluwatobiloba D Omoyele
• Valerie Ann Paige, LPC
• Pain Specialist of Michigan, PLLC
• Christopher R Papp, M.D.

• Public Health Dentistry in South Lyon, MI
• Providers in South Lyon, MI by specialty
• Public Health Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.