NPIMap

Organization Active NPI

Dental House - Waterford, PLLC

  • Dentist
  • Waterford TWP, MI
National Provider Identifier
1700418555
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL HOUSE - WATERFORD, PLLC
Practice address
5979 Highland Road
Waterford TWP, MI 48327
Phone
(734) 999-9909
NPI assigned
Feb 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Ramy Attalla, DMDNPI 1538540901
Title
Ceo
Phone
(804) 539-6622

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

5979 Highland Road
Waterford TWP, MI 48327

Mailing address

4860 Washtenaw Ave Ste D
Ann Arbor, MI 48108-3401
Phone (804) 539-6622

National Provider Directory

National Provider Directory

Locations

5979 Highland Rd
Waterford, MI 48327
Phone (734) 999-9909

Practitioners & affiliated clinicians

Practitioners 3

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": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1700418555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 WASHTENAW AVE STE D",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083401",
            "telephone_number": "804-539-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 HIGHLAND ROAD",
            "city": "WATERFORD TWP",
            "state": "MI",
            "postal_code": "48327",
            "telephone_number": "734-999-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HOUSE - WATERFORD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "ATTALLA",
        "authorized_official_first_name": "RAMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-539-6622",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.