NPIMap

Organization Active NPI

Kennedy Dental Center of Michigan, P.C.

Doing business as Kennedy Dental Center

  • General Practice Dentistry
  • Lincoln Park, MI
National Provider Identifier
1619026085
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017849 Issued in MI
Legal business name
KENNEDY DENTAL CENTER OF MICHIGAN, P.C.
Doing business as
Kennedy Dental Center
Practice address
1193 Southfield Rd
Lincoln Park, MI 48146-2450
Phone
(313) 388-1800
Fax
(313) 388-5527
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mirza M Baig, D.D.S.NPI 1396706347
Title
Owner
Phone
(248) 755-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2901017849 MI Primary

Addresses

Primary practice location

1193 Southfield Rd
Lincoln Park, MI 48146-2450

Mailing address

23800 Orchard Lake Rd
Ste. 106
Farmington Hills, MI 48336-2560
Phone (248) 755-5700

Other names 1

  • Kennedy Dental Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619026085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23800 ORCHARD LAKE RD",
            "address_2": "STE. 106",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362560",
            "telephone_number": "248-755-5700",
            "fax_number": "248-471-7383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 SOUTHFIELD RD",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462450",
            "telephone_number": "313-388-1800",
            "fax_number": "313-388-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY DENTAL CENTER OF MICHIGAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAIG",
        "authorized_official_first_name": "MIRZA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-755-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln Park, MI

Sources for this page

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