Dearborn Ear Nose and Throat Clinic

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

4301026530 Issued in MI

Legal business name

DEARBORN EAR NOSE AND THROAT CLINIC

Practice address

15212 Michigan Ave
Dearborn, MI 48126-3497

Phone

(313) 582-8853

Fax

(313) 582-6417

NPI assigned

Apr 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John Austin Fink, MD

Title

Physician

Phone

(313) 582-8853

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1932374394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15212 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263497",
            "telephone_number": "313-582-8853",
            "fax_number": "313-582-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15212 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263497",
            "telephone_number": "313-582-8853",
            "fax_number": "313-582-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN EAR NOSE AND THROAT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "FINK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "313-582-8853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301026530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1796837",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MI",
            "identifier": "0821564",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dearborn Community Dental Center P.C.
• Dearborn Community Pharmacy LLC (independent community pharmacy)
• Dearborn Dental Care
• Dearborn Dental Group PC
• Dearborn Dental Group West
• Dearborn Family Clinic, P.C.
• Dearborn Family Dental LLC
• Dearborn Family Dentistry PC
• Dearborn Family Pharmacy
• Dearborn Family Pharmacy LLC (Family Pharmacy LTC)

• Otolaryngology Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.