Wolverine Cosmetic Dental L.L.C

Primary specialty

DentistTaxonomy code 122300000X

License

2901019508 Issued in MI

Legal business name

WOLVERINE COSMETIC DENTAL L.L.C

Practice address

17070 W. 12 Mile Rd
C
Southfield, MI 48076-2116

Phone

(248) 395-4700

Fax

(248) 395-4703

NPI assigned

Jul 25, 2008

Organization subpart

No

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

Authorized official

Name

Sahar Barbat, D.D.S

Title

Doctor

Phone

(248) 395-4700

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Karen E. Eggleston, D.D.S.

  • General Practice Dentistry
  • Southfield, MI
  • NPI 1770611006
  NPD (past)

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1881859239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17070 W 12 MILE RD",
            "address_2": "C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762116",
            "telephone_number": "248-395-4700",
            "fax_number": "248-395-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17070 W. 12 MILE RD",
            "address_2": "C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762116",
            "telephone_number": "248-395-4700",
            "fax_number": "248-395-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLVERINE COSMETIC DENTAL L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "BARBAT",
        "authorized_official_first_name": "SAHAR",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "248-395-4700",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497949945",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437252467",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Patrick Wolfe, PT, DPT
• Michelle Dawn Wolfe, MD
• Sandra Dee Wolfe, LPN
• Kelly Lynn Wolowiec
• Mark E Wolowiec, DDS
• Sally Womack
• Womans Touch PLLC
• Won Medical Group PC
• Grace Wong, LLMSW
• Madilyn L Wood

• Dentist in Southfield, MI
• Providers in Southfield, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.