Elite Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

2901018195 Issued in MI

Legal business name

ELITE DENTAL GROUP

Practice address

1658 Middlebelt Rd
Garden City, MI 48135-2879

Phone

(734) 421-1181

Fax

(734) 421-4538

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kalil Abraham, D.D.S.

Title

Owner

Phone

(734) 421-1181

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700901956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 MIDDLEBELT RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352879",
            "telephone_number": "734-421-1181",
            "fax_number": "734-421-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 MIDDLEBELT RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352879",
            "telephone_number": "734-421-1181",
            "fax_number": "734-421-4538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "KALIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-421-1181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Durecki, RN
• Kevin Durell, D.O.
• Mountaha Eidy, DO
• Vita Randazzo Eizans, D.O.
• Shurook Sufian Elassouli, MD
• Elite Dental Groups
• Elite Home Physicians PLLC
• Elite Medical Equipment Inc
• Elite Transport, Inc
• Ahmed Atef Elkomy, MD

• Dentist in Garden City, MI
• Providers in Garden City, MI by specialty
• Dentist in Michigan

• 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.