Erich a. Dittmar, DDS, MSD, PC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

2901016477 Issued in MI

Legal business name

ERICH A. DITTMAR, DDS, MSD, PC

Doing business as

Kensington Valley Endodontics, PC

Practice address

10415 Grand River Rd
Suite 400
Brighton, MI 48116-6533

Phone

(810) 225-9630

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Erich Alexander Dittmar, D.D.S.NPI 1265619514

Title

President

Phone

(810) 225-9630

Specialties & licenses 1

Addresses

Other names 1

• Kensington Valley Endodontics, PC Doing business as

Locations

Practitioners 1

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

• Erich Alexander Dittmar, DDS

  • Endodontics
  • Brighton, MI
  • NPI 1265619514
  NPD (past) Authorized official

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1881735066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10415 E. GRAND RIVER RD",
            "address_2": "SUITE 400",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "48116",
            "telephone_number": "810-225-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 GRAND RIVER RD",
            "address_2": "SUITE 400",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481166533",
            "telephone_number": "810-225-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICH A. DITTMAR, DDS, MSD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "DITTMAR",
        "authorized_official_first_name": "ERICH",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-225-9630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MI",
            "license": "2901016477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kensington Valley Endodontics, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endodontics in Brighton, MI
• Providers in Brighton, MI by specialty
• Endodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.