NPIMap

Organization Active NPI

Children's Dental Specialists PLLC

  • Pediatric Dentistry
  • Troy, MI
National Provider Identifier
1740668268
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CHILDREN'S DENTAL SPECIALISTS PLLC
Practice address
2240 Livernois Rd
Troy, MI 48083-1664
Phone
(248) 528-0500
Fax
(248) 528-0555
NPI assigned
May 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Authorized official

Name
Dr. Ifechide NwabuezeNPI 1043591472
Title
Dr
Phone
(248) 528-0500

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

2240 Livernois Rd
Troy, MI 48083-1664

Mailing address

2240 Livernois Rd
Troy, MI 48083-1664
Phone (248) 528-0500

National Provider Directory

National Provider Directory

Locations

2240 Livernois Rd
Troy, MI 48083
Phone (248) 528-0500

Practitioners & affiliated clinicians

Practitioners 7

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": "1431734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1740668268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831664",
            "telephone_number": "248-528-0500",
            "fax_number": "248-528-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831664",
            "telephone_number": "248-528-0500",
            "fax_number": "248-528-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S DENTAL SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-16",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "NWABUEZE",
        "authorized_official_first_name": "IFECHIDE",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "248-528-0500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.