Childrens Dental Specialists of Hazel Park PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CHILDRENS DENTAL SPECIALISTS OF HAZEL PARK PLLC

Practice address

22241 John R Rd
Hazel Park, MI 48030-1716

Phone

(248) 336-0356

Fax

(248) 336-0357

NPI assigned

Mar 18, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ifechide Nwabueze

Title

President

Phone

(248) 336-0356

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1780143982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22241 JOHN R RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301716",
            "telephone_number": "248-336-0356",
            "fax_number": "248-336-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22241 JOHN R RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301716",
            "telephone_number": "248-336-0356",
            "fax_number": "248-336-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS DENTAL SPECIALISTS OF HAZEL PARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "NWABUEZE",
        "authorized_official_first_name": "IFECHIDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-336-0356",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Eye Care PC
• Christopher Yon Chang, M.D.
• Jose Cyriac Chazhikat, P.T.
• Sindhu Jose Chazhikat, P.T.
• Childrens Dental Program PLLC
• City of Hazel Park
• Jillian Clark, MA
• Matthew Cleary Jr.
• Compassionate Growth Counseling PLLC
• Heather Marie Craft

• All providers in Hazel Park, MI
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.