NPIMap

Organization Active NPI

Detroit Receiving Hospital & University Health Center

  • Oral and Maxillofacial Surgery Clinic/Center
  • Detroit, MI
National Provider Identifier
1497939607
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
261QS0112X Issued in MI
Legal business name
DETROIT RECEIVING HOSPITAL & UNIVERSITY HEALTH CENTER
Practice address
4201 Saint Antoine St
Detroit, MI 48201-2153
Phone
(313) 578-2164
Fax
(313) 578-3964
NPI assigned
Dec 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Ms. Gloria Larkins, VICE PRESIDENT
Title
Vice President Finance
Phone
(313) 578-2164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 261QS0112X MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
Detroit, MI 48201-2153

Mailing address

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 578-2164

Other identifiers 1

IdentifierTypeStateIssuer
0H27931OtherMIBCBSM PROVIDER ID

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1497939607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-578-2164",
            "fax_number": "313-578-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-578-2164",
            "fax_number": "313-578-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT RECEIVING HOSPITAL & UNIVERSITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "LARKINS",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "313-578-2164",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "VICE PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "261QS0112X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PROVIDER ID",
            "identifier": "0H27931",
            "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 Mar 24, 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.