Individual provider Active NPI

Socorro Barie

  • Dental Hygienist
  • Detroit, MI
National Provider Identifier
1417488453
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2902014742 Issued in MI
Practice address
60 E Warren Ave FL 2
Detroit, MI 48201-1312
Phone
(313) 626-2600
Fax
(313) 482-9750
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2902014742 MI Primary

Addresses

Primary practice location

60 E Warren Ave FL 2
Detroit, MI 48201-1312

Mailing address

14887 Evergreen Rd
Detroit, MI 48223-2101
Phone (313) 415-6368

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
2902014742MIMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1417488453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14887 EVERGREEN RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232101",
            "telephone_number": "313-415-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 E WARREN AVE FL 2",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011312",
            "telephone_number": "313-626-2600",
            "fax_number": "313-482-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARIE",
        "first_name": "SOCORRO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902014742",
            "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 Mar 22, 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.