Active NPI
Daja Whiteside
- Nurse Practitioner
- Southfield, MI
National Provider Identifier
1740133180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704335567
- Practice address
- 21431 Buttercrest St
Southfield, MI 48075-3916 - Phone
- (248) 990-6632
- NPI assigned
- Feb 17, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704335567 | MI | Primary |
Addresses
Primary practice location
21431 Buttercrest St
Southfield, MI 48075-3916
Mailing address
21431 Buttercrest St
Southfield, MI 48075-3916
Phone (248) 990-6632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704335567 | MI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771286400000",
"number": "1740133180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21431 BUTTERCREST ST",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480753916",
"telephone_number": "248-990-6632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21431 BUTTERCREST ST",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480753916",
"telephone_number": "248-990-6632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITESIDE",
"first_name": "DAJA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-17",
"last_updated": "2026-02-17",
"certification_date": "2026-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704335567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.