Great Expressions Dental Centers Douglas Dziuba DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREAT EXPRESSIONS DENTAL CENTERS DOUGLAS DZIUBA DDS INC

Doing business as

Great Expression Dental Centers

Practice address

29777 Telegraph Rd Ste 3000
Southfield, MI 48034-7634

Phone

(248) 203-1100

Fax

(248) 203-1112

NPI assigned

Jan 29, 2007

Last updated

Feb 11, 2019By 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

Douglas Dziuba

Title

Owner

Phone

(248) 203-1100

Specialties & licenses 1

Addresses

Other names 1

• Great Expression Dental Centers Doing business as

Locations

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1427194216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29777 TELEGRAPH RD STE 3000",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347634",
            "telephone_number": "248-203-1100",
            "fax_number": "248-203-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29777 TELEGRAPH RD STE 3000",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347634",
            "telephone_number": "248-203-1100",
            "fax_number": "248-203-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT EXPRESSIONS DENTAL CENTERS DOUGLAS DZIUBA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "DZIUBA",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-203-1100"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Expression Dental Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Expression Dental Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.