Prime Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PRIME DENTAL PLLC

Practice address

32905 W 12 Mile Rd Ste 140
Farmington Hills, MI 48334-3343

Phone

(248) 987-2879

Fax

(248) 715-6367

NPI assigned

Jan 4, 2019

Organization subpart

No

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

Authorized official

Name

Sona Fisenkova, DDSNPI 1811380751

Title

Doctor/Owner

Phone

(248) 987-2879

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

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

• Sona Fisenkova

  • General Practice Dentistry
  • Farmington Hills, MI
  • NPI 1811380751
  NPD Authorized official

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670198400000",
    "number": "1720551500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32905 W 12 MILE RD STE 140",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343343",
            "telephone_number": "248-987-2879",
            "fax_number": "248-715-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32905 W 12 MILE RD STE 140",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343343",
            "telephone_number": "248-987-2879",
            "fax_number": "248-715-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-04",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "FISENKOVA",
        "authorized_official_first_name": "SONA",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "248-987-2879",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE 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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELF",
            "identifier": "1811380751",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raven Priest
• Leandra Marie Priestly
• Hilario Gabriel Prieto
• Tiffany N Priggett
• Primary Choice Home Care of Michigan, LLC.
• Prime Health Care PC
• Michael Primero-Predgo
• Mariah Primero
• Tuyishimire Primitiva
• Jalin Primm

• Dentist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.