Individual provider Active NPI

Stephen Andrew Dakhlian, R. PH.

  • Geriatric Pharmacist
  • Southfield, MI
National Provider Identifier
1467590091
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric PharmacistTaxonomy code 1835G0303X
License
5302022917 Issued in MI
Practice address
29877 Telegraph Rd
Southfield, MI 48034-1332
Phone
(248) 354-5600
NPI assigned
Feb 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X 5302022917 MI
Long Term Care Pharmacy 3336L0003X
Geriatric Pharmacist 1835G0303X 5302022917 MI Primary

Addresses

Primary practice location

29877 Telegraph Rd
Southfield, MI 48034-1332

Mailing address

358 Sycamore CT
Bloomfield Hills, MI 48302-1172

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302022917MIMDLong Term Care Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1467590091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 SYCAMORE CT",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483021172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341332",
            "telephone_number": "248-354-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKHLIAN",
        "first_name": "STEPHEN",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "R. PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5302022917",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "MI",
            "license": "5302022917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.