Preferred Dental Assoc PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PREFERRED DENTAL ASSOC PLLC

Practice address

6765 Orchard Lake Rd
West Bloomfield, MI 48322

Phone

(248) 851-6166

Fax

(248) 851-0012

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Nizar Naum Mansour, DDS MS

Title

Partner

Phone

(248) 851-6166

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669540498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6765 ORCHARD LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "48322",
            "telephone_number": "248-851-6166",
            "fax_number": "248-851-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6765 ORCHARD LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "48322",
            "telephone_number": "248-851-6166",
            "fax_number": "248-851-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED DENTAL ASSOC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "NIZAR",
        "authorized_official_middle_name": "NAUM",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "248-851-6166",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anuradha Yarlagadda Prasad, MD
• Madhu-Ashni Prasad, PA-C
• Amanda Prater, MA, BCBA, LBA
• Praveen Modi, MD, PC
• Precision Foot and Ankle Center PLLC
• Premier Foot & Ankle II PLLC
• Premier Foot & Ankle PLLC
• Premier Home Care, Inc.
• Premier Therapy Centers, Inc
• Sarah Presley, PA-C

• General Practice Dentistry in West Bloomfield, MI
• Providers in West Bloomfield, 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 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.