Organization Active NPI

Ez Dentist PLLC

  • Dentist
  • Novi, MI
National Provider Identifier
1558126763
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
EZ DENTIST PLLC
Practice address
27150 Providence Pkwy Ste B
Novi, MI 48374-1272
Phone
(280) 270-8315
NPI assigned
Feb 16, 2024
Last updated
Mar 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Harjot VirkNPI 1447532072
Title
Dr
Phone
(313) 915-0015

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
Dentist 122300000X Primary

Addresses

Primary practice location

27150 Providence Pkwy Ste B
Novi, MI 48374-1272

Mailing address

27072 Debiasi Dr
Brownstown, MI 48174
Phone (313) 915-0015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240319002592 MI Part B Supplier - Clinic/Group Practice 4880031434 Receives reassigned benefits from 1 practitioner
Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

27150 Providence Pkwy
Novi, MI 48374

27150 Providence Pkwy
Ste B
Novi, MI 48374
Phone (280) 270-8315

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1558126763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27072 DEBIASI DR",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "48174",
            "telephone_number": "313-915-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27150 PROVIDENCE PKWY STE B",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741272",
            "telephone_number": "280-270-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZ DENTIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "VIRK",
        "authorized_official_first_name": "HARJOT",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "313-915-0015"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.