Organization Active NPI

Bright Side Dental-Warren PLLC

  • General Practice Dentistry
  • Warren, MI
National Provider Identifier
1609229954
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BRIGHT SIDE DENTAL-WARREN PLLC
Practice address
28609 Hoover Rd
Warren, MI 48093-4105
Phone
(586) 751-8585
Fax
(586) 751-8446
NPI assigned
Jul 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Peatris Sabbagh
Title
Chief Operating Officer
Phone
(248) 971-7435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

28609 Hoover Rd
Warren, MI 48093-4105

Mailing address

28609 Hoover Rd
Warren, MI 48093-4105
Phone (586) 751-8585

National Provider Directory

National Provider Directory

Locations

28609 Hoover Rd
Warren, MI 48093
Phone (586) 217-2547

Practitioners & affiliated clinicians

Practitioners 4

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": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1609229954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28609 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934105",
            "telephone_number": "586-751-8585",
            "fax_number": "586-751-8446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28609 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934105",
            "telephone_number": "586-751-8585",
            "fax_number": "586-751-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT SIDE DENTAL-WARREN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "SABBAGH",
        "authorized_official_first_name": "PEATRIS",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "248-971-7435"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.