NPIMap

Organization Active NPI

Endodontic Associates of Michigan PLLC

  • Endodontics
  • Clinton TWP, MI
National Provider Identifier
1891742607
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
ENDODONTIC ASSOCIATES OF MICHIGAN PLLC
Practice address
15870 19 Mile Road
Ste 110
Clinton TWP, MI 48038
Phone
(586) 286-3390
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Dr. Gerald C Dietz Jr., DDS
Title
Partner Doctor
Phone
(248) 647-7930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

15870 19 Mile Road
Ste 110
Clinton TWP, MI 48038

Mailing address

15870 19 Mile Road
Ste 110
Clinton TWP, MI 48038
Phone (586) 286-3390

Other names 1

  • Endodontic Associates Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Endodontic Associates9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15870 19 Mile Rd
Ste 110
Clinton Twp, MI 48038
Phone (586) 286-3390

15870 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 268-5520

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1891742607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15870 19 MILE ROAD",
            "address_2": "STE 110",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "48038",
            "telephone_number": "586-286-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15870 19 MILE ROAD",
            "address_2": "STE 110",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "48038",
            "telephone_number": "586-286-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC ASSOCIATES OF MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER DOCTOR",
        "authorized_official_telephone_number": "248-647-7930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endodontic Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.