NPIMap

Organization Active NPI

D2 Dental of Michigan, P.C.

Doing business as Destiny Dental

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1437671799
Registry record updated Jul 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
D2 DENTAL OF MICHIGAN, P.C.
Doing business as
Destiny Dental
Practice address
14736 Mack Ave
Detroit, MI 48215-2524
Phone
(313) 412-2100
NPI assigned
Jul 8, 2017
Last updated
Jul 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2017

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

Authorized official

Name
Mr. Boris Labinov
Title
Agent
Phone
(708) 613-4542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

14736 Mack Ave
Detroit, MI 48215-2524

Mailing address

137 N Oak Park Ave Ste 310
Oak Park, IL 60301-1339

Other names 1

  • Destiny Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
D2 Dental of Michigan PC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

14736 Mack Ave
Detroit, MI 48215
Phone (313) 412-2100

NPI Registry JSON

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

{
    "created_epoch": "1499472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499472000000",
    "number": "1437671799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE STE 310",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14736 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152524",
            "telephone_number": "313-412-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D2 DENTAL OF MICHIGAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-08",
        "last_updated": "2017-07-08",
        "status": "A",
        "authorized_official_last_name": "LABINOV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "708-613-4542",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Destiny Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 8, 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.