Kakaris Family Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

014845 Issued in MI

Legal business name

KAKARIS FAMILY DENTISTRY PC

Practice address

21080 Allen Rd
Suite a
Woodhaven, MI 48183-1602

Phone

(734) 676-1656

Fax

(734) 362-8662

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Arestea Athanasios Kakaris, DDS

Title

Ceo

Phone

(734) 676-1656

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477766327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21080 ALLEN RD",
            "address_2": "SUITE A",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831602",
            "telephone_number": "734-676-1656",
            "fax_number": "734-362-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21080 ALLEN RD",
            "address_2": "SUITE A",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831602",
            "telephone_number": "734-676-1656",
            "fax_number": "734-362-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAKARIS FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAKARIS",
        "authorized_official_first_name": "ARESTEA",
        "authorized_official_middle_name": "ATHANASIOS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-676-1656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "014845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "1223G0001X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Joganic, LMSW
• Brittany Renee Johnson, RBT
• Lindsay Michelle Johnson, DDS
• Annemarie Jucha
• Anna Lynn Jurado, P.T.
• Alexander Athanasios Kakaris Porter, DDS
• Arestea Athanasios Kakaris, DDS
• Anijolta Kambo-Gjelaj, DDS
• Kasey Thomas, Ma, Bcba, LLC
• Olivia Raffaella-Anna Keenan, P.A.-C

• General Practice Dentistry in Woodhaven, MI
• Providers in Woodhaven, 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 22, 2020; 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.