NPIMap

Organization Active NPI

Moosa Family Dentistry, PLLC

  • Dental Clinic/Center
  • Marysville, MI
National Provider Identifier
1700468345
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MOOSA FAMILY DENTISTRY, PLLC
Practice address
650 Huron Blvd
Marysville, MI 48040-1427
Phone
(810) 364-9060
NPI assigned
Apr 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Authorized official

Name
Dr. Fadi Moosa, DDSNPI 1134657927
Title
Dentist
Phone
(248) 990-3575

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

650 Huron Blvd
Marysville, MI 48040-1427

Mailing address

650 Huron Blvd
Marysville, MI 48040-1427
Phone (810) 364-9060

Other names 1

  • Bright Pointe Doing business as

National Provider Directory

National Provider Directory

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": "1619136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1700468345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HURON BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401427",
            "telephone_number": "810-364-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HURON BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401427",
            "telephone_number": "810-364-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOOSA FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "MOOSA",
        "authorized_official_first_name": "FADI",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "248-990-3575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright Pointe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marysville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.