Organization Active NPI

Epic Smile Centers of Michigan PLLC

  • Dental Clinic/Center
  • Farmington Hills, MI
National Provider Identifier
1730647272
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EPIC SMILE CENTERS OF MICHIGAN PLLC
Practice address
30969 Orchard Lake Rd
Farmington Hills, MI 48334-1338
Phone
(866) 374-2764
NPI assigned
Mar 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Authorized official

Name
Dr. Jared Woolf, DDSNPI 1487662417
Title
Manager
Phone
(561) 866-3040

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

30969 Orchard Lake Rd
Farmington Hills, MI 48334-1338

Mailing address

17968 Fieldbrook Cir S
Boca Raton, FL 33496-1531
Phone (561) 866-3040

Other practice location 1

732 W Big Beaver Rd
Troy, MI 48084-4934
Phone (866) 374-2764

Other practice location 2

45001 Ford Rd # 104-D
Canton, MI 48187-2907
Phone (561) 866-3040

Other identifiers 1

IdentifierTypeStateIssuer
1770628687OtherMIDENTIST

National Provider Directory

National Provider Directory

Locations

45001 Ford Rd
#104D
Canton, MI 48187
Phone (561) 866-3040

732 W Big Beaver Rd
Troy, MI 48084
Phone (248) 897-0202

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": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1730647272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17968 FIELDBROOK CIR S",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334961531",
            "telephone_number": "561-866-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30969 ORCHARD LAKE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341338",
            "telephone_number": "866-374-2764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 W Big Beaver Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480844934",
            "country_code": "US",
            "telephone_number": "866-374-2764",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45001 Ford Rd # 104-D",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481872907",
            "country_code": "US",
            "telephone_number": "561-866-3040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EPIC SMILE CENTERS OF MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A",
        "authorized_official_last_name": "WOOLF",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-866-3040",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "1770628687",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.