NPIMap

Organization Active NPI

Raffic a. Mackie D.D.S., P.C.

  • Dentist
  • Dearborn, MI
National Provider Identifier
1912108440
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11656 Issued in MI
Legal business name
RAFFIC A. MACKIE D.D.S., P.C.
Practice address
9925 Dix
Suite 101
Dearborn, MI 48120-1593
Phone
(313) 841-5522
Fax
(313) 841-8170
NPI assigned
May 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Kimberly Goutimy
Title
Office Manager
Phone
(313) 841-5522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 11656 MI Primary

Addresses

Primary practice location

9925 Dix
Suite 101
Dearborn, MI 48120-1593

Mailing address

9925 Dix
Suite 101
Dearborn, MI 48120-1593
Phone (313) 841-5522

National Provider Directory

National Provider Directory
Tax ID family
Raffic a Mackie DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9925 Dix
Ste 101
Dearborn, MI 48120
Phone (313) 841-5522

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912108440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 DIX",
            "address_2": "SUITE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201593",
            "telephone_number": "313-841-5522",
            "fax_number": "313-841-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 DIX",
            "address_2": "SUITE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201593",
            "telephone_number": "313-841-5522",
            "fax_number": "313-841-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAFFIC A. MACKIE D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOUTIMY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-841-5522",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "11656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.