Individual provider Active NPI

Peter Joseph Namou, DDS

  • General Practice Dentistry
  • Clinton Township, MI
National Provider Identifier
1417486275
Registry record updated Aug 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901022218 Issued in MI
Practice address
42550 Garfield Rd Ste 104B
Clinton Township, MI 48038-1644
Phone
(586) 228-2800
NPI assigned
Jun 6, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901022218 MI Primary

Addresses

Primary practice location

42550 Garfield Rd Ste 104B
Clinton Township, MI 48038-1644

Mailing address

6856 Aurora Dr
Troy, MI 48098-2005
Phone (248) 217-4671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901022218MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Namou Dental Care PLLC General Practice CurrentSince Aug 11, 2024 Accepting new patients

Locations

42550 Garfield Rd
Ste 104B
Clinton Twp, MI 48038
Phone (586) 228-2800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722729600000",
    "number": "1417486275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6856 AURORA DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982005",
            "telephone_number": "248-217-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42550 GARFIELD RD STE 104B",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381644",
            "telephone_number": "586-228-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMOU",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-06",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2024; 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.