NPIMap

Organization Active NPI

Wayne County Health Department

  • Dentist
  • Wayne, MI
National Provider Identifier
1821250184
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WAYNE COUNTY HEALTH DEPARTMENT
Practice address
33030 Van Born Rd
Wayne, MI 48184-2453
Phone
(734) 727-7208
Fax
(737) 727-7005
NPI assigned
Jun 27, 2008
Last updated
Jun 27, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WAYNE COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Mr. James Banaszak
Title
Accounting Supervisor
Phone
(734) 727-7208

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901012332 MI
Dentist 122300000X 2901011217 MI
Dentist 122300000X 2901010538 MI
Dentist 122300000X NU Primary

Addresses

Primary practice location

33030 Van Born Rd
Wayne, MI 48184-2453

Mailing address

33030 Van Born Rd
Wayne, MI 48184-2453
Phone (734) 727-7208

Other identifiers 3

IdentifierTypeStateIssuer
741846106MedicaidMI
744045109MedicaidMI
744054000MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Det Metro Wayne Cty Air11 organizations share this tax ID, including this one
Part of
Det Metro Wayne Cty Air

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1821250184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33030 VAN BORN RD",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842453",
            "telephone_number": "734-727-7208",
            "fax_number": "737-727-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33030 VAN BORN RD",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842453",
            "telephone_number": "734-727-7208",
            "fax_number": "737-727-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNE COUNTY",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "BANASZAK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ACCOUNTING SUPERVISOR",
        "authorized_official_telephone_number": "734-727-7208",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901012332",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901011217",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901010538",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "741846106",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744045109",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744054000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.