NPIMap

Organization Active NPI

Centerline Denture Clinic

  • Dental Clinic/Center
  • Center Line, MI
National Provider Identifier
1497900302
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
4963 Issued in MI
Legal business name
CENTERLINE DENTURE CLINIC
Practice address
24625 Van Dyke Ave
Center Line, MI 48015-2303
Phone
(586) 756-5880
NPI assigned
Nov 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Authorized official

Name
Mrs. Renee K Elliott
Title
Office Manager
Phone
(586) 756-5880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 4963 MI Primary

Addresses

Primary practice location

24625 Van Dyke Ave
Center Line, MI 48015-2303

Mailing address

24625 Van Dyke Ave
Center Line, MI 48015-2303
Phone (586) 756-5880

National Provider Directory

National Provider Directory
Tax ID family
Centerline Denture Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1497900302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24625 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480152303",
            "telephone_number": "586-756-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24625 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480152303",
            "telephone_number": "586-756-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERLINE DENTURE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-756-5880",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "4963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Line, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.