Star Dental P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901018555 Issued in MI

Legal business name

STAR DENTAL P.C.

Practice address

775 Baldwin Rd
Suite C
Pontiac, MI 48340

Phone

(248) 338-3000

Fax

(248) 338-3173

NPI assigned

Mar 10, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Siran S. Raouf, DDSNPI 1396812269

Title

President

Phone

(248) 338-3000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Siran Salah Raouf, DDS

  • General Practice Dentistry
  • Pontiac, MI
  • NPI 1396812269
  NPD (past) Authorized official

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1750822748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 BALDWIN RD",
            "address_2": "SUITE C",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48340",
            "telephone_number": "248-338-3000",
            "fax_number": "248-338-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 BALDWIN RD",
            "address_2": "SUITE C",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48340",
            "telephone_number": "248-338-3000",
            "fax_number": "248-338-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "RAOUF",
        "authorized_official_first_name": "SIRAN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-338-3000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Pontiac, MI
• Providers in Pontiac, 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 Mar 10, 2017; 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.