Arbor Blue Family Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ARBOR BLUE FAMILY DENTAL PLLC

Doing business as

Stadium Family Dentistry of Ann Arbor

Practice address

2340 E Stadium Blvd Ste 6
Ann Arbor, MI 48104-4823

Phone

(734) 994-5353

NPI assigned

Jun 16, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Hetal S Patel, DDSNPI 1780995043

Title

Owner

Phone

(734) 994-5353

Specialties & licenses 1

Addresses

Other names 1

• Stadium Family Dentistry of Ann Arbor Doing business as

Practitioners 1

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

• Hetal Sujal Patel, D.D.S.

  • Dentist
  • Canton, MI
  • NPI 1780995043
  NPD Authorized official

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655337600000",
    "number": "1891425351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 PORTSMAN CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872177",
            "telephone_number": "313-598-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 E STADIUM BLVD STE 6",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044823",
            "telephone_number": "734-994-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBOR BLUE FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "HETAL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-994-5353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stadium Family Dentistry of Ann Arbor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.