Individual provider Active NPI

Deidre Alford

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1831235654
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901019231 Issued in MI
Practice address
511 W 8 Mile Rd
Detroit, MI 48203-1004
Phone
(313) 891-7330
NPI assigned
Jan 29, 2007
Last updated
Apr 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901019231 MI Primary

Addresses

Primary practice location

511 W 8 Mile Rd
Detroit, MI 48203-1004

Mailing address

511 W 8 Mile Rd
Detroit, MI 48203-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170310001840 MI Practitioner - Dentist 5193024552 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Plan Medical Centers CurrentSince Feb 4, 2017 Accepting new patients
The Wellness Plan Medical Centers CurrentSince Feb 4, 2017 Accepting new patients
Detroit Central City Community Mental Health Inc. Current Accepting new patients
Detroit Central City Community Mental Health Inc. CurrentSince Apr 3, 2024 Accepting new patients
Detroit Central City Community Mental Health, Inc. CurrentSince Apr 3, 2024 Accepting new patients
Detroit Central City Community Mental Health, Inc. Past Accepting new patients

Locations

10 Peterboro St
Detroit, MI 48201
Phone (313) 221-8595

1240 3rd St
Detroit, MI 48226
Phone (313) 635-4213

2888 W Grand Blvd
Detroit, MI 48202
Phone (313) 875-4200

21040 Greenfield Rd
Oak Park, MI 48237
Phone (248) 967-1888

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCBDCD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1831235654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482031004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482031004",
            "telephone_number": "313-891-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFORD",
        "first_name": "DEIDRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.