Active NPI
Richard Iain Tann, DDS
- Pediatric Dentistry
- Detroit, MI
National Provider Identifier
1669722856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 290102739
- Practice address
- 79 W Alexandrine St FL 3
Detroit, MI 48201-2015 - Phone
- (313) 576-2551
- Fax
- (313) 576-2556
- NPI assigned
- Sep 14, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 290102739 | MI | Primary |
Addresses
Primary practice location
79 W Alexandrine St FL 3
Detroit, MI 48201-2015
Mailing address
1479 Pope Street
Lasalle, ONTARIO N9J3R8
CA
Phone (519) 819-2555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 290102739 | MI | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347580800000",
"number": "1669722856",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "1479 POPE STREET",
"city": "LASALLE",
"state": "ONTARIO",
"postal_code": "N9J3R8",
"telephone_number": "519-819-2555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 W ALEXANDRINE ST FL 3",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012015",
"telephone_number": "313-576-2551",
"fax_number": "313-576-2556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANN",
"first_name": "RICHARD",
"middle_name": "IAIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-14",
"last_updated": "2012-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MI",
"license": "290102739",
"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 Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.