NPIMap

Organization Active NPI

St Apollonia Denttal

  • Dentist
  • Sterling Heights, MI
National Provider Identifier
1689068876
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901013190 Issued in MI
Legal business name
ST APOLLONIA DENTTAL
Practice address
43158 Dequindre Rd
Sterling Heights, MI 48314-1723
Phone
(586) 323-1320
Fax
(586) 323-1530
NPI assigned
Mar 25, 2015
Last updated
Mar 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Authorized official

Name
Dr. Charles Patrick Pearson, DDSNPI 1811042484
Title
Owner
Phone
(586) 323-1320

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 2901013190 MI Primary

Addresses

Primary practice location

43158 Dequindre Rd
Sterling Heights, MI 48314-1723

Mailing address

43158 Dequindre Rd
Sterling Heights, MI 48314-1723
Phone (586) 323-1320

National Provider Directory

National Provider Directory
Tax ID family
Charles Pearson DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

43158 Dequindre Rd
Sterling Hts, MI 48314
Phone (586) 323-1320

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1689068876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43158 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141723",
            "telephone_number": "586-323-1320",
            "fax_number": "586-323-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43158 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141723",
            "telephone_number": "586-323-1320",
            "fax_number": "586-323-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST APOLLONIA DENTTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-323-1320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901013190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.