Walcottdental, PLC

Primary specialty

DentistTaxonomy code 122300000X

License

2901019587 Issued in MI

Legal business name

WALCOTTDENTAL, PLC

Practice address

1910 Packard St
Ste. 1
Ann Arbor, MI 48104-4734

Phone

(734) 994-3700

NPI assigned

Oct 5, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Brett J Walcott, D.D.S

Title

Partner/Owner

Phone

(734) 994-3700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1457801169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PACKARD ST",
            "address_2": "STE. 1",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044734",
            "telephone_number": "734-994-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PACKARD ST",
            "address_2": "STE. 1",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044734",
            "telephone_number": "734-994-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALCOTTDENTAL, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "WALCOTT",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "734-994-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Walainis, PT, DPT
• Annette Walblay, N.P.
• Carolyn Forbes Walborn, RN,MS,CPNP
• Brett J Walcott, D.D.S.
• Wayne Eugene Walcott, DDS MS
• Crytal Walcutt
• Erica Wald, R.D.
• Jerry Samuel Walden, M.D.
• Julie A Walden, LMSW
• Jeffrey Chase Waldman, M.D

• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.