Professional Dental Alliance of Burton, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PROFESSIONAL DENTAL ALLIANCE OF BURTON, PLLC

Practice address

2414 S Center Rd Ste 1
Burton, MI 48519-1152

Phone

(810) 744-3388

Fax

(810) 744-4080

NPI assigned

Jul 28, 2020

Organization subpart

No

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

Authorized official

Name

Erica Quinteros

Title

Credentialing Supervisor

Phone

(724) 698-2135

Specialties & licenses 1

Addresses

Other names 1

• Refresh Dental Burton Doing business as

Locations

Practitioners 1

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

• Raouf Alsebei

  • Dentist
  • Burton, MI
  • NPI 1760222137
  NPD

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1740899541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680",
            "telephone_number": "724-698-2500",
            "fax_number": "844-399-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 S CENTER RD STE 1",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191152",
            "telephone_number": "810-744-3388",
            "fax_number": "810-744-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF BURTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "QUINTEROS",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "724-698-2135"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Refresh Dental Burton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ariel Ponce, D.O.
• Anthony Joseph Ponsetto, D.D.S.
• Phillip C. Popham, O.D.
• Eleni Poutakidou
• Jasemin Nicole Powell
• Professional Hearing Inc
• Tatiana Prozhoga
• Carmen Lee Pruett, LLMSW
• Psalms & Purpose Home Care LLC
• Quality Dental Services of Michigan, PC

• General Practice Dentistry in Burton, MI
• Providers in Burton, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.