Active NPI
C'Vaeo Edwards, DDS
- Dentist
- Southfield, MI
National Provider Identifier
1881419554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901602327
- Practice address
- 16800 W 12 Mile Rd Ste 103
Southfield, MI 48076-6335 - Phone
- (248) 443-5371
- NPI assigned
- Nov 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901602327 | MI | Primary |
Addresses
Primary practice location
16800 W 12 Mile Rd Ste 103
Southfield, MI 48076-6335
Mailing address
16800 W 12 Mile Rd Ste 103
Southfield, MI 48076-6335
Phone (248) 443-5371
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901602327 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731888000000",
"number": "1881419554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16800 W 12 MILE RD STE 103",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480766335",
"telephone_number": "248-443-5371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16800 W 12 MILE RD STE 103",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480766335",
"telephone_number": "248-443-5371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "C'VAEO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-11-18",
"last_updated": "2024-11-18",
"certification_date": "2024-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901602327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.