NPIMap

Organization Active NPI

Lincoln Park Family Dentistry DDS PC

  • Dentist
  • Lincoln Park, MI
National Provider Identifier
1649371121
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12305 Issued in MI
Legal business name
LINCOLN PARK FAMILY DENTISTRY DDS PC
Practice address
3326 Fort St
Lincoln Park, MI 48146
Phone
(313) 381-0343
Fax
(313) 386-0331
NPI assigned
Sep 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Stewart S Markofsky, DDSNPI 1932302528
Title
President
Phone
(313) 381-0343

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 12305 MI Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 12551 MI
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 12122 MI

Addresses

Primary practice location

3326 Fort St
Lincoln Park, MI 48146

Mailing address

3326 Fort Street
Lincoln Park, MI 48146
Phone (313) 381-0343

National Provider Directory

National Provider Directory

Locations

3326 Fort St
Lincoln Park, MI 48146
Phone (313) 381-0343

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": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649371121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 FORT STREET",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "48146",
            "telephone_number": "313-381-0343",
            "fax_number": "313-386-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "48146",
            "telephone_number": "313-381-0343",
            "fax_number": "313-386-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PARK FAMILY DENTISTRY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARKOFSKY",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-381-0343",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "12305",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "12551",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "12122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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.