Organization Active NPI

A1 Family Dentistry of Waterford,PLC

  • Dental Clinic/Center
  • Waterford, MI
National Provider Identifier
1578023883
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
A1 FAMILY DENTISTRY OF WATERFORD,PLC
Practice address
2759 Elizabeth Lake Rd
Waterford, MI 48328-3291
Phone
(586) 226-0638
NPI assigned
Mar 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Authorized official

Name
Dr. Aneel Kaur Randhawa, DDSNPI 1790841633
Title
Owner
Phone
(586) 226-0638

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2759 Elizabeth Lake Rd
Waterford, MI 48328-3291

Mailing address

50481 Koss Dr
Macomb, MI 48044-6320
Phone (586) 226-0638

National Provider Directory

National Provider Directory

Locations

2759 Elizabeth Lake Rd
Waterford, MI 48328
Phone (248) 681-4470

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": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1578023883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50481 KOSS DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480446320",
            "telephone_number": "586-226-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283291",
            "telephone_number": "586-226-0638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A1 FAMILY DENTISTRY OF WATERFORD,PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "RANDHAWA",
        "authorized_official_first_name": "ANEEL",
        "authorized_official_middle_name": "KAUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-226-0638",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.