NPIMap

Organization Active NPI

Community Dentistry Plus,P,C

  • General Practice Dentistry
  • Lathrup Village, MI
National Provider Identifier
1689798530
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29010109220 Issued in MI
Legal business name
COMMUNITY DENTISTRY PLUS,P,C
Practice address
18161 W 12 Mile Rd
Suit 2
Lathrup Village, MI 48076-2662
Phone
(248) 790-3738
Fax
(248) 552-3777
NPI assigned
Mar 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Khayri KassabNPI 1578743605
Title
Owner Dentist
Phone
(248) 790-3738

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 29010109220 MI Primary

Addresses

Primary practice location

18161 W 12 Mile Rd
Suit 2
Lathrup Village, MI 48076-2662

Mailing address

30480 Shoreham St
Southfield, MI 48076-5368
Phone (248) 790-3738

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1174176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1689798530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30480 SHOREHAM ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480765368",
            "telephone_number": "248-790-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18161 W 12 MILE RD",
            "address_2": "SUIT 2",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762662",
            "telephone_number": "248-790-3738",
            "fax_number": "248-552-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTISTRY PLUS,P,C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-18",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "KASSAB",
        "authorized_official_first_name": "KHAYRI",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "248-790-3738"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "29010109220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lathrup Village, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.