Individual provider Active NPI

George Ziyadeh

  • General Practice Dentistry
  • Detroit, MI
National Provider Identifier
1891831632
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901016510 Issued in MI
Practice address
11180 Gratiot Ave
Detroit, MI 48213-1363
Phone
(313) 245-1780
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901016510 MI Primary

Addresses

Primary practice location

11180 Gratiot Ave
Detroit, MI 48213-1363

Mailing address

11180 Gratiot Ave
Detroit, MI 48213-1363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122001293 MI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2062604846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gentle Dental Shores PLLC PastSince Apr 11, 2010 Accepting new patients
Gentle Dental Gratiot Ave PLLC PastSince Jul 1, 2011 Accepting new patients
Detroit - Gratiot P.C. Past Accepting new patients
Family Dental Group Associates PLLC PastSince Jun 1, 2011 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891831632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482131363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482131363",
            "telephone_number": "313-245-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIYADEH",
        "first_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.