NPIMap

Organization Active NPI

Professional Endodontics

  • Endodontics
  • Southfield, MI
National Provider Identifier
1679797609
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
PROFESSIONAL ENDODONTICS
Practice address
29201 Telegraph Rd
Suite 110
Southfield, MI 48034-1331
Phone
(248) 358-2910
Fax
(248) 358-2479
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dominick Shoha, D.D.S.NPI 1275678575
Title
President
Phone
(248) 358-2910

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)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X MI Primary

Addresses

Primary practice location

29201 Telegraph Rd
Suite 110
Southfield, MI 48034-1331

Mailing address

29201 Telegraph Rd
Suite 110
Southfield, MI 48034-1331
Phone (248) 358-2910

National Provider Directory

National Provider Directory

Locations

29201 Telegraph Rd
Ste 110
Southfield, MI 48034
Phone (248) 358-2910

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679797609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD",
            "address_2": "SUITE 110",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341331",
            "telephone_number": "248-358-2910",
            "fax_number": "248-358-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29201 TELEGRAPH RD",
            "address_2": "SUITE 110",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341331",
            "telephone_number": "248-358-2910",
            "fax_number": "248-358-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHOHA",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-358-2910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • 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.