NPIMap

Organization Active NPI

Louay Mansour DDS PC

  • Dentist
  • Roseville, MI
National Provider Identifier
1437761400
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LOUAY MANSOUR DDS PC
Practice address
27845 Gratiot Avenue
Roseville, MI 48066
Phone
(586) 455-2990
NPI assigned
Aug 20, 2020
Last updated
Oct 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Authorized official

Name
Mr. Louay Mansour, DDS
Title
Owner
Phone
(586) 445-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

27845 Gratiot Avenue
Roseville, MI 48066

Mailing address

27845 Gratoit Ave.
Roseville, MI 48066
Phone (568) 445-2990

National Provider Directory

National Provider Directory
Tax ID family
Divine Family Denistry2 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.

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602547200000",
    "number": "1437761400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27845 GRATOIT AVE.",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "48066",
            "telephone_number": "568-445-2990",
            "fax_number": "586-445-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27845 GRATIOT AVENUE",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "48066",
            "telephone_number": "586-455-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUAY MANSOUR DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "LOUAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-445-2990",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.