NPIMap

Organization Active NPI

Marty M. Powell DDS PC

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1497068175
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14298 Issued in MI
Legal business name
MARTY M. POWELL DDS PC
Practice address
14356 E Jefferson Ave
Detroit, MI 48215-2932
Phone
(313) 824-9890
Fax
(313) 824-9894
NPI assigned
Jul 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Authorized official

Name
Dr. Marty M Powell, D.D.S.NPI 1154540227
Title
Owner
Phone
(313) 824-9890

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 14298 MI Primary

Addresses

Primary practice location

14356 E Jefferson Ave
Detroit, MI 48215-2932

Mailing address

14356 E Jefferson Ave
Detroit, MI 48215-2932
Phone (313) 824-9890

Other names 1

  • Powell Dental Association Doing business as

National Provider Directory

National Provider Directory

Locations

14356 E Jefferson Ave
Detroit, MI 48215
Phone (313) 824-9890

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1497068175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14356 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152932",
            "telephone_number": "313-824-9890",
            "fax_number": "313-824-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14356 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152932",
            "telephone_number": "313-824-9890",
            "fax_number": "313-824-9894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTY M. POWELL DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "MARTY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-824-9890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "14298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powell Dental Association",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 22, 2010; 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.