NPIMap

Organization Active NPI

Zoma Dental Practice PLLC

Doing business as Zoma Dental

  • Dentist
  • West Bloomfield, MI
National Provider Identifier
1619582301
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ZOMA DENTAL PRACTICE PLLC
Doing business as
Zoma Dental
Practice address
6330 Orchard Lake Rd Ste 130
West Bloomfield, MI 48322-2398
Phone
(248) 932-0550
NPI assigned
Sep 10, 2020
Last updated
Mar 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Authorized official

Name
Dr. Jacqueline Zoma, DDSNPI 1144667684
Title
Dentist
Phone
(248) 807-1420

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

6330 Orchard Lake Rd Ste 130
West Bloomfield, MI 48322-2398

Mailing address

6330 Orchard Lake Rd Ste 130
West Bloomfield, MI 48322-2398
Phone (248) 932-0550

Other identifiers 1

IdentifierTypeStateIssuer
1223G001XOtherMIDENTAL INSURANCE CARRIERS

Other names 1

  • Zoma Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1619582301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 ORCHARD LAKE RD STE 130",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222398",
            "telephone_number": "248-932-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 ORCHARD LAKE RD STE 130",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222398",
            "telephone_number": "248-932-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZOMA DENTAL PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "ZOMA",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "248-807-1420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL INSURANCE CARRIERS",
            "identifier": "1223G001X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zoma Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Zoma Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.