NPIMap

Organization Active NPI

42 North Dental Care of Michigan, PLLC

Doing business as Great Lakes Family Dental, Livonia

  • Dental Clinic/Center
  • Livonia, MI
National Provider Identifier
1871233775
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
42 NORTH DENTAL CARE OF MICHIGAN, PLLC
Doing business as
Great Lakes Family Dental, Livonia
Practice address
16160 Middlebelt Rd
Livonia, MI 48154-3338
Phone
(734) 261-9696
NPI assigned
Mar 30, 2022
Last updated
Mar 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
42 NORTH DENTAL CARE OF MICHIGAN, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Authorized official

Name
Michael Angelo Scialabba
Title
Chief Clinical Officer
Phone
(561) 512-2709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

16160 Middlebelt Rd
Livonia, MI 48154-3338

Mailing address

16160 Middlebelt Rd
Livonia, MI 48154-3338

Other names 1

  • Great Lakes Family Dental, Livonia Doing business as

National Provider Directory

National Provider Directory
Tax ID family
42 North Dental Care of Michigan PLLC12 organizations share this tax ID, including this one
Part of
42 North Dental Care of Michigan PLLC

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1871233775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16160 MIDDLEBELT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16160 MIDDLEBELT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543338",
            "telephone_number": "734-261-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "42 NORTH DENTAL CARE OF MICHIGAN, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "42 NORTH DENTAL CARE OF MICHIGAN, PLLC",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "SCIALABBA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANGELO",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "561-512-2709"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Family Dental, Livonia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.