Individual provider Active NPI

Deanna Mike Beydoun, DDS

  • Dentist
  • Plymouth, MI
National Provider Identifier
1447176078
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901603138 Issued in MI
Practice address
11272 Fellows Creek Dr
Plymouth, MI 48170-6382
Phone
(313) 932-9174
NPI assigned
Jun 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901603138 MI Primary

Addresses

Primary practice location

11272 Fellows Creek Dr
Plymouth, MI 48170-6382

Mailing address

11272 Fellows Creek Dr
Plymouth, MI 48170-6382
Phone (313) 932-9174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1782432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1447176078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11272 FELLOWS CREEK DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706382",
            "telephone_number": "313-932-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11272 FELLOWS CREEK DR",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706382",
            "telephone_number": "313-932-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYDOUN",
        "first_name": "DEANNA",
        "middle_name": "MIKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-26",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901603138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.