Fortson Dentistry Lathrup North

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FORTSON DENTISTRY LATHRUP NORTH

Practice address

27445 Southfield Rd
Lathrup Village, MI 48076-3411

Phone

(248) 423-9000

Fax

(248) 569-7409

NPI assigned

Feb 22, 2018

Organization subpart

No

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

Authorized official

Name

Jamie Soli

Title

Regional Manager

Phone

(248) 398-5400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1669973970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27445 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480763411",
            "telephone_number": "248-423-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27445 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480763411",
            "telephone_number": "248-423-9000",
            "fax_number": "248-569-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTSON DENTISTRY LATHRUP NORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "SOLI",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "248-398-5400"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Matters Counseling and Educational Agency LLC
• Rodolfo D Farhy, MD
• Focus Diagnostics
• For Your Eyes Only
• Fortson Dental, P.C.
• Fortson Family Dentistry, P.C.
• Payaum Fotovat-Ahmadi, MD
• Erin Lee Fox, R.D.
• Renee Fricke, LMT
• Hadassah Friedman

• All providers in Lathrup Village, MI
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.