Bloomfield Hills Dental Group PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

BLOOMFIELD HILLS DENTAL GROUP PLLC

Practice address

43902 Woodward Ave Ste 220
Bloomfield Hills, MI 48302-5022

Phone

(248) 335-4427

Fax

(248) 332-2014

NPI assigned

Jun 5, 2021

Organization subpart

No

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

Authorized official

Name

Omar ElbanhawyNPI 1780994533

Title

Owner

Phone

(248) 335-4427

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 2

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

• Omar E Elbanhawy, DDS, MS

  • Periodontics
  • Grosse Pointe, MI
  • NPI 1780994533
  NPD Authorized official
• Joseph Samona, DDS

  • Dentist
  • Sterling Heights, MI
  • NPI 1023636446
  NPD (past)

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

{
    "created_epoch": "1622851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622851200000",
    "number": "1902473374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43902 WOODWARD AVE STE 220",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025022",
            "telephone_number": "248-335-4427",
            "fax_number": "248-332-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43902 WOODWARD AVE STE 220",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025022",
            "telephone_number": "248-335-4427",
            "fax_number": "248-332-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD HILLS DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-05",
        "last_updated": "2021-06-05",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "ELBANHAWY",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-335-4427"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staff@bloomfieldhillsdentist.com",
            "affiliation": "N",
            "address_1": "43902 Woodward Ave Ste 220",
            "city": "Bloomfield Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483025022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bloomfield Dental Care, P.C.
• Bloomfield Dental Group PC
• Bloomfield Family
• Bloomfield Foot & Ankle Specialists PLLC
• Bloomfield Hills Care Group, Inc.
• Bloomfield Hills Massage LLC
• Bloomfield Hills Pediatrics
• Bloomfield Hills Rehab, LLC
• Bloomfield Hills SNF LLC
• Bloomfield Hills Surgery Center

• Periodontics in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2021; 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.