Professional Dental Alliance of Mi - LMTD, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF MI - LMTD, PLLC

Practice address

27891 23 Mile Rd.
Chesterfield, MI 48051

Phone

(856) 840-8050

Fax

(586) 690-4470

NPI assigned

Dec 15, 2022

Organization subpart

No

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

Authorized official

Name

Erica Quinteros

Title

Credentialing

Phone

(724) 901-1964

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Danielle Lucy Dawisha, DDS

  • General Practice Dentistry
  • Mount Clemens, MI
  • NPI 1255991204
  NPD (past)
• Gabrielle M Mercieca, DDS

  • General Practice Dentistry
  • South Lyon, MI
  • NPI 1528801214
  NPD (past)

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1447962055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ENTERPRISE DR STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751223",
            "telephone_number": "726-901-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27891 23 MILE RD.",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "48051",
            "telephone_number": "856-840-8050",
            "fax_number": "586-690-4470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22181 Pontiac Trl",
            "address_purpose": "LOCATION",
            "city": "South Lyon",
            "state": "MI",
            "postal_code": "48178",
            "country_code": "US",
            "telephone_number": "248-491-7116",
            "fax_number": "248-864-7401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF MI - LMTD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "QUINTEROS",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "724-901-1964"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lynn Pridemore
• Nirahia Primm
• Alexandria Prince
• Matthew James Prior, D.O.
• Ra'Kiya Pritchett
• Progressions, LLC
• La'Kisha Proper
• Sydney Provost
• Lacellia Pruitt
• Alicia Pung

• General Practice Dentistry in Chesterfield, MI
• Providers in Chesterfield, 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 Aug 9, 2023; 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.