NPIMap

Organization Active NPI

Detroit Dental Specialist, PC

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1649576299
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018887 Issued in MI
Legal business name
DETROIT DENTAL SPECIALIST, PC
Practice address
15510 Livernois
Detroit, MI 48238
Phone
(313) 863-2800
NPI assigned
Jan 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Authorized official

Name
Dr. George Stec, DDS
Title
President
Phone
(313) 863-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 2901018887 MI Primary

Addresses

Primary practice location

15510 Livernois
Detroit, MI 48238

Mailing address

PO Box 38367
Detroit, MI 48238
Phone (313) 863-2800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1649576299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38367",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48238",
            "telephone_number": "313-863-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15510 LIVERNOIS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48238",
            "telephone_number": "313-863-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT DENTAL SPECIALIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-31",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "STEC",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-863-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.