Forever Young Dentistry Bayside PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FOREVER YOUNG DENTISTRY BAYSIDE PC

Practice address

36555 26 Mile Rd Ste 3900
Lenox, MI 48048-3190

Phone

(586) 277-0080

NPI assigned

Oct 10, 2023

Organization subpart

No

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

Authorized official

Name

Susan Marshall

Title

Financial Coordinator

Phone

(586) 795-5678

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Alyssa Jacobs, DDS

  • Dentist
  • Madison Heights, MI
  • NPI 1861131658
  NPD
• Joseph Samona, DDS

  • Dentist
  • Sterling Heights, MI
  • NPI 1023636446
  NPD
• Michael Lloyd Young, D.D.S.

  • Dentist
  • Sterling Heights, MI
  • NPI 1083835391
  NPD

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1760263248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39242 DEQUINDRE RD STE 106",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483101767",
            "telephone_number": "586-795-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36555 26 MILE RD STE 3900",
            "city": "LENOX",
            "state": "MI",
            "postal_code": "480483190",
            "telephone_number": "586-277-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER YOUNG DENTISTRY BAYSIDE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "586-795-5678"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Early Solution Clinic
• Dominique Elya, MA, LLPC
• Eli Farhy
• Dean Joseph Fitch, DO
• Tara Elaine Fletcher, FNP
• Christopher J Frocillo, D.O.
• Lauren Lee Gauthier, NP-C
• Eric Gootee, PHARM.D.
• Heart Bridge Home Care LLC
• Katherine Holdwick, FNP-C

• General Practice Dentistry in Lenox, MI
• Providers in Lenox, 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 Oct 10, 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.