Midwestern Dental of Detroit

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

N/A Issued in NU

Legal business name

MIDWESTERN DENTAL OF DETROIT

Practice address

1415 Trumbull St
Detroit, MI 48216-1368

Phone

(313) 963-2222

Fax

(313) 963-3665

NPI assigned

May 8, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Morgan Jr.

Title

Administrative Director

Phone

(313) 582-8150

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760431936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263249",
            "telephone_number": "313-582-8150",
            "fax_number": "313-582-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 TRUMBULL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482161368",
            "telephone_number": "313-963-2222",
            "fax_number": "313-963-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWESTERN DENTAL OF DETROIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "313-582-8150",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midtown RX Pharmacy Inc
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• Midway RX LLC
• Midwest Comfort Care Inc.
• Midwest-Woodbridge Health Center,P.C.
• Marisa Quinn Mieczkowski
• Andrew John Mielcuszny, DO
• Colleen Larose Miele, MD
• Anna Marie Mier, LMSW
• Stephen D Migdal, MD

• General Practice Dentistry in Detroit, MI
• Providers in Detroit, 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 Aug 22, 2020; 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.