Eastside Implants & Periodontics

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

EASTSIDE IMPLANTS & PERIODONTICS

Doing business as

Eastside Implants & Periodontics

Practice address

25523 Van Dyke Ave
Center Line, MI 48015-1824

Phone

(586) 757-5454

Fax

(586) 757-4147

NPI assigned

Nov 3, 2022

Organization subpart

Yes

Parent organization

MICHIGAN IMPLANTS & PERIODONTICS INSTITUTE, P.L.C.As reported in NPPES

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

Authorized official

Name

Dr. Waleed Rhebi, DDS

Title

Periodontist

Phone

(586) 757-5454

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eastside Implants & Periodontics Doing business as

Electronic endpoints 1

Tax ID family

Eastside Implants and Periodontics2 organizations share this tax ID, including this one

Part of

Michigan Implants Periodontics Institute PLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eastside Implants and Periodontics

  • Periodontics
  • Center Line, MI
  • NPI 1932946464
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Michigan Implants & Periodontics Institute, P.L.C.

  • Periodontics
  • Ann Arbor, MI
  • NPI 1194962753
  NPPES parent name

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1750098224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25523 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151824",
            "telephone_number": "586-757-5454",
            "fax_number": "586-757-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25523 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151824",
            "telephone_number": "586-757-5454",
            "fax_number": "586-757-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE IMPLANTS & PERIODONTICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHIGAN IMPLANTS & PERIODONTICS INSTITUTE, P.L.C.",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "RHEBI",
        "authorized_official_first_name": "WALEED",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "586-757-5454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447709662",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@eastsideimplants.com",
            "affiliation": "N",
            "endpointDescription": "Office Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "25523 Van Dyke Ave",
            "city": "Center Line",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480151824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Eastside Implants & Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Drew, LMSW
• Meaghan Elizabeth Duma
• Danielle Rose Durant
• Easterseals Morc Health Care Inc.
• Eastpointe Hearing Aid Services, LLC
• Eastside Implants and Periodontics
• Eastside Periodontal Assoc PLLC
• Roba Elkhalil, M.D.
• Hossni I Elzein, D.D.S.
• Kandis Epifanio

• Periodontics in Center Line, MI
• Providers in Center Line, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.