Active NPI
Eastside Family Dentistry
- General Practice Dentistry
- Shelby Township, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901016598
- Legal business name
- EASTSIDE FAMILY DENTISTRY
- Practice address
- 48926 Schoenherr Rd.
Shelby Township, MI 48315 - Phone
- (586) 566-5660
- NPI assigned
- Apr 7, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Fadi George Keyorkgy, D.D.S., M.S.D.
- Title
- Owner
- Phone
- (586) 566-5660
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901016598 | MI | Primary |
Addresses
Primary practice location
48926 Schoenherr Rd.
Shelby Township, MI 48315
Mailing address
48926 Schoenherr Rd.
Shelby Township, MI 48315
Phone (586) 566-5660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3369505 | Medicaid | MI |
National Provider Directory
National Provider Directory- Tax ID family
- Eastland Family Dentistry
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Detroit, MI
- NPI 1285880872
Locations
48926 Schoenherr Rd
Shelby Township, MI 48315
Phone (586) 566-5660
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Detroit, MI
- NPI 1508908492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270598400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1270598400000",
"number": "1649595232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48926 SCHOENHERR RD.",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "48315",
"telephone_number": "586-566-5660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48926 SCHOENHERR RD.",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "48315",
"telephone_number": "586-566-5660"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EASTSIDE FAMILY DENTISTRY",
"organizational_subpart": "NO",
"enumeration_date": "2010-04-07",
"last_updated": "2010-04-07",
"status": "A",
"authorized_official_last_name": "KEYORKGY",
"authorized_official_first_name": "FADI",
"authorized_official_middle_name": "GEORGE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "586-566-5660",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S., M.S.D."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901016598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3369505",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.