NPIMap

Organization Active NPI

Family Dentistry

  • Dental Clinic/Center
  • Dearborn, MI
National Provider Identifier
1497928493
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2901015608 Issued in MI
Legal business name
FAMILY DENTISTRY
Practice address
10326 W Warren Ave
Suite 2
Dearborn, MI 48126-1659
Phone
(313) 581-0717
Fax
(313) 581-3590
NPI assigned
Apr 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Mr. Mohammed W Imam
Title
Owner
Phone
(313) 581-0710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2901015608 MI Primary

Addresses

Primary practice location

10326 W Warren Ave
Suite 2
Dearborn, MI 48126-1659

Mailing address

10326 W Warren Ave
Suite 2
Dearborn, MI 48126-1659
Phone (313) 581-0717

Other identifiers 1

IdentifierTypeStateIssuer
1649320722OtherMINPI

National Provider Directory

National Provider Directory

Locations

10326 W Warren Ave
Ste 2
Dearborn, MI 48126
Phone (313) 581-0717

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1497928493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10326 W WARREN AVE",
            "address_2": "SUITE 2",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261659",
            "telephone_number": "313-581-0717",
            "fax_number": "313-581-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10326 W WARREN AVE",
            "address_2": "SUITE 2",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261659",
            "telephone_number": "313-581-0717",
            "fax_number": "313-581-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "IMAM",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-581-0710",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "2901015608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649320722",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

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