NPIMap

Organization Active NPI

Grace Dental Care LLC

  • Dentist
  • Madison Heights, MI
National Provider Identifier
1699808477
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901017954 Issued in MI
Legal business name
GRACE DENTAL CARE LLC
Practice address
30825 John R Rd
Madison Heights, MI 48071
Phone
(248) 588-8966
Fax
(248) 577-0073
NPI assigned
Mar 13, 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. Betty Lee Nguyen, DDSNPI 1417154535
Title
Dentist Owner
Phone
(248) 588-8966

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 2901017954 MI Primary

Addresses

Primary practice location

30825 John R Rd
Madison Heights, MI 48071

Mailing address

30825 John R Rd
Madison Heights, MI 48071
Phone (248) 588-8966

National Provider Directory

National Provider Directory

Locations

30825 John R Rd
Madison Heights, MI 48071
Phone (248) 588-8966

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": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699808477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30825 JOHN R RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48071",
            "telephone_number": "248-588-8966",
            "fax_number": "248-577-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30825 JOHN R RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48071",
            "telephone_number": "248-588-8966",
            "fax_number": "248-577-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "248-588-8966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901017954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, 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.