Detroit Optical Co

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002904 Issued in MI

Legal business name

DETROIT OPTICAL CO

Doing business as

Pearle Vision Northland

Practice address

32987 Woodward Ave
Royal Oak, MI 48073-0958

Phone

(248) 549-9080

Fax

(248) 549-4770

NPI assigned

Oct 7, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth B Foon, O.D.

Title

President

Phone

(248) 549-9080

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Pearle Vision Northland Doing business as

Locations

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1740278357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32987 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730958",
            "telephone_number": "248-549-9080",
            "fax_number": "248-549-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32987 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730958",
            "telephone_number": "248-549-9080",
            "fax_number": "248-549-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT OPTICAL CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "FOON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-549-9080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002904",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002916",
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI",
            "identifier": "900F377270",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision Northland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Varsha Ganesh Deshmukh, MD
• Gianna Desimone, DO
• Justin Taylor Deslaurier, MD
• Destiny Dorozan-Dunkin, Ma, LLP, LLC
• Detroit Integrated Care PLLC (Detroit Integrated Care)
• Sharadashree Devarahally, MD
• Kathryn Hodson Devereux, P.T., D.P.T.
• Alegra Rose Devour, DPT
• Samuel Dewitt, DO
• David Dewitte

• Optometrist in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.