Individual provider Active NPI

Imhoitsemeh Dako

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
National Provider Identifier
1669228110
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014
Phone
(313) 346-5235
NPI assigned
Apr 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014

Mailing address

25 Cabin Creek Dr
Jackson, TN 38305-6105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250912003457 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5193228237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1669228110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CABIN CREEK DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023014",
            "telephone_number": "313-346-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKO",
        "first_name": "IMHOITSEMEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.