NPIMap

Organization Active NPI

Carolin Ibrahim DDS MSD PLLC

Doing business as Everest Endodontics

  • Endodontics
  • Woodhaven, MI
National Provider Identifier
1457068470
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
CAROLIN IBRAHIM DDS MSD PLLC
Doing business as
Everest Endodontics
Practice address
22601 Allen Rd Ste 400
Woodhaven, MI 48183-2273
Phone
(734) 767-2067
NPI assigned
Oct 31, 2022
Last updated
Dec 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Authorized official

Name
Dr. Carolin Ibrahim, DDS, MSDNPI 1275974883
Title
Doctor
Phone
(248) 759-8831

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU Primary

Addresses

Primary practice location

22601 Allen Rd Ste 400
Woodhaven, MI 48183-2273

Mailing address

11360 Pacentro Cir
Sterling Heights, MI 48312-1278

Other names 1

  • Everest Endodontics Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Www.everestendo.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671753600000",
    "number": "1457068470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11360 PACENTRO CIR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483121278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22601 ALLEN RD STE 400",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481832273",
            "telephone_number": "734-767-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLIN IBRAHIM DDS MSD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "CAROLIN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "248-759-8831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Www.everestendo.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "22601 Allen Rd Ste 400",
            "city": "Woodhaven",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481832273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Everest Endodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Everest Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodhaven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.