NPIMap

Organization Active NPI

Dina Elhout DDS PC

Doing business as Center for Modern Dentistry

  • Prosthodontics
  • Dearborn, MI
National Provider Identifier
1790216315
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
2901020729 Issued in MI
Legal business name
DINA ELHOUT DDS PC
Doing business as
Center for Modern Dentistry
Practice address
430 N Telegraph Rd
Dearborn, MI 48128-1619
Phone
(313) 563-6601
Fax
(313) 563-6986
NPI assigned
Mar 24, 2017
Last updated
Mar 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Authorized official

Name
Yasser Alali, DDSNPI 1184987075
Title
Dentist/Owner
Phone
(313) 563-6601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901021238 MI
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 2901021098 MI
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 2901020729 MI Primary

Addresses

Primary practice location

430 N Telegraph Rd
Dearborn, MI 48128-1619

Mailing address

430 N Telegraph Rd
Dearborn, MI 48128-1619
Phone (313) 563-6601

Other names 1

  • Center for Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

430 N Telegraph Rd
Dearborn, MI 48128
Phone (313) 563-6601

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1790216315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N TELEGRAPH RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281619",
            "telephone_number": "313-563-6601",
            "fax_number": "313-563-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N TELEGRAPH RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281619",
            "telephone_number": "313-563-6601",
            "fax_number": "313-563-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DINA ELHOUT DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "ALALI",
        "authorized_official_first_name": "YASSER",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "313-563-6601",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021238",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901021098",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "2901020729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.