Wyandotte Family Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901014390 Issued in MI

Legal business name

WYANDOTTE FAMILY DENTAL, PLLC

Practice address

2244 Ford Ave
Wyandotte, MI 48192-2316

Phone

(734) 282-2019

Fax

(734) 282-1976

NPI assigned

Sep 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Susan Jean Cleereman, DDS

Title

Owner

Phone

(734) 282-2019

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Leroy F Wojewodzic, D.D.S.

  • Dentist
  • Wyandotte, MI
  • NPI 1295922524
  NPD (past)

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1689823536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2244 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922316",
            "telephone_number": "734-282-2019",
            "fax_number": "734-282-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2244 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922316",
            "telephone_number": "734-282-2019",
            "fax_number": "734-282-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOTTE FAMILY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "CLEEREMAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-282-2019",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2721984",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa Wood, DO
• Lastasia Cierra Woods
• Woodward Detroit CVS, L.L.C.
• Lisa Lynn Woolley, M.A. CCC-SLP
• Wyandotte Chiropractic Clinic, PLLC
• Wyandotte Hospital Practices
• Wyandotte Internal Medicine Associates
• Wyandotte Medical Practices
• Wyandotte Medical Practices
• Wyandotte Medical Practices

• General Practice Dentistry in Wyandotte, MI
• Providers in Wyandotte, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.