NPIMap

Organization Active NPI

Professional Dental Alliance of Rochester, PLLC

  • Dentist
  • Rochester, MI
National Provider Identifier
1871005074
Registry record updated Oct 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PROFESSIONAL DENTAL ALLIANCE OF ROCHESTER, PLLC
Practice address
600 N Main St Ste 100
Rochester, MI 48307-1491
Phone
(248) 652-1010
NPI assigned
Oct 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2017

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

Authorized official

Name
Annette Marlow
Title
Credentialing Supervisor
Phone
(724) 698-2119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

600 N Main St Ste 100
Rochester, MI 48307-1491

Mailing address

11 S Mill St Ste 200
New Castle, PA 16101-3680
Phone (724) 968-2500

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509062400000",
    "number": "1871005074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MILL ST STE 200",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161013680",
            "telephone_number": "724-968-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MAIN ST STE 100",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071491",
            "telephone_number": "248-652-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF ROCHESTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-27",
        "last_updated": "2017-10-27",
        "status": "A",
        "authorized_official_last_name": "MARLOW",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "724-698-2119"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2017; 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.