Royal Oak Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ROYAL OAK FAMILY DENTISTRY

Practice address

28 Oakland Park Blvd
Pleasant Ridge, MI 48069-1109

Phone

(248) 543-7070

Fax

(248) 543-3520

NPI assigned

May 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Gergory Costello

Title

Office Manager

Phone

(248) 543-7070

Specialties & licenses 1

Addresses

Tax ID family

Royal Oak Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Royal Oak Family Dentistry

  • General Practice Dentistry
  • Royal Oak, MI
  • NPI 1205815628
  NPD tax ID

Locations

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417907312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S WASHINGTON AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673222",
            "telephone_number": "248-543-7070",
            "fax_number": "248-543-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 OAKLAND PARK BLVD",
            "city": "PLEASANT RIDGE",
            "state": "MI",
            "postal_code": "480691109",
            "telephone_number": "248-543-7070",
            "fax_number": "248-543-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL OAK FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "GERGORY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-543-7070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Pleasant Ridge, MI
• Providers in Pleasant Ridge, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.