Southfield Family Dental Center PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHFIELD FAMILY DENTAL CENTER PLLC

Practice address

18800 W 10 Mile Rd
Southfield, MI 48075-2654

Phone

(248) 569-6304

NPI assigned

Apr 14, 2022

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649894400000",
    "number": "1639812050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18800 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752654",
            "telephone_number": "248-569-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18800 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752654",
            "telephone_number": "248-569-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD FAMILY DENTAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southfield Dental Care P.C.
• Southfield Dental Center PC
• Southfield Dental PLLC
• Southfield Essential Care PLLC
• Southfield Family Dental Center
• Southfield Family Foot Center, P.C.
• Southfield Family Physicians, PLLC
• Southfield Family Practice PLLC
• Southfield Gastroenterology Associates PC
• Southfield Gum Docs, LLC (Michigan Gum Docs)

• General Practice Dentistry in Southfield, MI
• Providers in Southfield, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.