NPIMap

Organization Active NPI

Vernor Dental Care

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1467616292
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
018429 Issued in MI
Legal business name
VERNOR DENTAL CARE
Practice address
8044 W Vernor Hwy
Detroit, MI 48209
Phone
(313) 843-4003
Fax
(313) 842-9311
NPI assigned
Jul 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Danissa David
Title
Office Manager
Phone
(313) 843-4003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 018429 MI Primary

Addresses

Primary practice location

8044 W Vernor Hwy
Detroit, MI 48209

Mailing address

8044 W Vernor Hwy
Detroit, MI 48209
Phone (313) 843-4003

Other identifiers 3

IdentifierTypeStateIssuer
4609947MedicaidMI
4873920MedicaidMI
4689868MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1467616292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8044 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48209",
            "telephone_number": "313-843-4003",
            "fax_number": "313-842-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8044 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48209",
            "telephone_number": "313-843-4003",
            "fax_number": "313-842-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNOR DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "DANISSA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-843-4003"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "018429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4609947",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4873920",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4689868",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.