Midwestern Periodontic Associates

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

N/A

Legal business name

MIDWESTERN PERIODONTIC ASSOCIATES

Practice address

5050 Schaefer Rd
Dearborn, MI 48126-3249

Phone

(313) 582-8150

Fax

(313) 582-6015

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

John Morgan Jr.

Title

Administrative Director

Phone

(313) 582-8150

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1821047879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263249",
            "telephone_number": "313-582-8150",
            "fax_number": "313-582-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263249",
            "telephone_number": "313-582-8150",
            "fax_number": "313-582-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWESTERN PERIODONTIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "313-582-8150",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; 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.