Active NPI
My Warren Dental
- General Practice Dentistry
- Warren, MI
National Provider Identifier
1790695765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- MY WARREN DENTAL
- Practice address
- 3456 E 12 Mile Rd Ste 2
Warren, MI 48092-2511 - Phone
- (586) 486-4600
- Fax
- (586) 486-4624
- NPI assigned
- Sep 10, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph Thayil, DDS
- Title
- President
- Phone
- (586) 486-4600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
3456 E 12 Mile Rd Ste 2
Warren, MI 48092-2511
Mailing address
3456 E 12 Mile Rd Ste 2
Warren, MI 48092-2511
Phone (586) 486-4600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1790695765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3456 E 12 MILE RD STE 2",
"city": "WARREN",
"state": "MI",
"postal_code": "480922511",
"telephone_number": "586-486-4600",
"fax_number": "586-486-4624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3456 E 12 MILE RD STE 2",
"city": "WARREN",
"state": "MI",
"postal_code": "480922511",
"telephone_number": "586-486-4600",
"fax_number": "586-486-4624"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MY WARREN DENTAL",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-10",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A",
"authorized_official_last_name": "THAYIL",
"authorized_official_first_name": "JOSEPH",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "586-486-4600",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.