Organization Active NPI

Fill Good Dental Care Inc

  • Dental Clinic/Center
  • Detroit, MI
National Provider Identifier
1417428780
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
FILL GOOD DENTAL CARE INC
Practice address
18595 Grand River Ave
Detroit, MI 48223
Phone
(313) 837-3000
Fax
(313) 838-4581
NPI assigned
Dec 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Authorized official

Name
Lawrence Wendell Stewart, DDS
Title
DDS/Owner
Phone
(313) 837-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

18595 Grand River Ave
Detroit, MI 48223

Mailing address

18595 Grand River Ave
Detroit, MI 48223
Phone (313) 837-3000

National Provider Directory

National Provider Directory

Locations

18595 Grand River Ave
Detroit, MI 48223
Phone (313) 832-0800

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1417428780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18595 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48223",
            "telephone_number": "313-837-3000",
            "fax_number": "313-838-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18595 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48223",
            "telephone_number": "313-837-3000",
            "fax_number": "313-838-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FILL GOOD DENTAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "WENDELL",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "313-837-3000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.