Supreme Dental PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SUPREME DENTAL PC

Practice address

27201 Ryan Rd
Warren, MI 48092-5127

Phone

(586) 558-8004

NPI assigned

Feb 3, 2014

Organization subpart

No

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

Authorized official

Name

Michele Bloxson

Title

President

Phone

(313) 416-6806

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391385600000",
    "number": "1891118352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27201 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27201 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925127",
            "telephone_number": "586-558-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-03",
        "last_updated": "2014-02-03",
        "status": "A",
        "authorized_official_last_name": "BLOXSON",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-416-6806"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lynette M Sutkowi Toomajian, DO
• Alexis Sutton
• William Sutton

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2014; 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.