Advanced Dental Clinic II PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ADVANCED DENTAL CLINIC II PLLC

Practice address

10645 W Warren Ave Ste 100
Dearborn, MI 48126-8009

Phone

(313) 908-1863

NPI assigned

Apr 22, 2019

Organization subpart

No

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

Authorized official

Name

Fadwa Sobh

Title

Manager

Phone

(313) 908-1863

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1811550221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10645 W WARREN AVE STE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481268009",
            "telephone_number": "313-908-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10645 W WARREN AVE STE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481268009",
            "telephone_number": "313-908-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL CLINIC II PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "SOBH",
        "authorized_official_first_name": "FADWA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "313-908-1863"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Dearborn, MI
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.