Portable Dental Services

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PORTABLE DENTAL SERVICES

Practice address

15055 22 Mile Rd # 2
Shelby TWP, MI 48315-4401

Phone

(586) 873-5567

NPI assigned

Sep 23, 2009

Last updated

Sep 23, 2009By 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

Robert Vance Antolak

Title

President

Phone

(586) 873-5567

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1437483484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15055 22 MILE RD # 2",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483154401",
            "telephone_number": "586-873-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15055 22 MILE RD # 2",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483154401",
            "telephone_number": "586-873-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTABLE DENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "ANTOLAK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "VANCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-873-5567"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinpoint Wellness Center, PC
• Pointe Family Dentistry-Shelby PLLC
• Catherine Polito, FNP
• Chris Polyzois, DPT
• David Pomaville
• Judi Potts
• Troy Benjamin Powell
• Precious Home Health Services Inc
• Prestige Home Care Assistance LLC
• Pro Med Management Inc

• General Practice Dentistry in Shelby TWP, MI
• Providers in Shelby TWP, 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 Sep 23, 2009; 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.