Livonia Laser Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901017025 Issued in MI

Legal business name

LIVONIA LASER DENTISTRY

Practice address

31632 Schoolcraft Rd
Livonia, MI 48150-1819

Phone

(734) 425-6920

Fax

(734) 425-1541

NPI assigned

Aug 9, 2018

Last updated

Aug 9, 2018By 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

Mr. Fady Mansour

Title

Admin

Phone

(734) 425-6920

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

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.

• Rula Raad Satar Al-Anbakey

  • Dentist
  • Livonia, MI
  • NPI 1790527059
  NPD (past)
• Alec House Pelc, DDS

  • General Practice Dentistry
  • Rochester, MI
  • NPI 1801408463
  NPD (past)
• Allan Jerome Warnick, DDS

  • Dentist
  • Livonia, MI
  • NPI 1154413730
  NPD (past)

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1811476955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31632 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501819",
            "telephone_number": "734-425-6920",
            "fax_number": "734-425-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31632 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501819",
            "telephone_number": "734-425-6920",
            "fax_number": "734-425-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVONIA LASER DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "FADY",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "734-425-6920",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13167481",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN PROFESSIONAL LICENSE - DENTISY",
            "identifier": "2901017025",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Livonia Family Physicians, PC
• Livonia Foot Surgeons PC
• Livonia Homecare
• Livonia Homecare LLC
• Livonia Internal Medicine Associates PC
• Livonia Life Center Corp
• Livonia Medical Center, P.C.
• Livonia Opco LLC (Medilodge of Livonia)
• Livonia Ophthalmologists PC
• Livonia Outpatient Surgery Center, LLC

• General Practice Dentistry in Livonia, MI
• Providers in Livonia, 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 9, 2018; 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.