Organization Active NPI

Bow Tie Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Waterford, MI
National Provider Identifier
1932800802
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
BOW TIE ORTHODONTICS
Practice address
2677 Elizabeth Lake Rd Ste 203
Waterford, MI 48328-3290
Phone
(248) 682-8811
NPI assigned
Mar 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Dr. James WilliamsNPI 1326601774
Title
Owner
Phone
(313) 530-7096

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2677 Elizabeth Lake Rd Ste 203
Waterford, MI 48328-3290

Mailing address

2677 Elizabeth Lake Rd Ste 203
Waterford, MI 48328-3290

Other practice location 1

732 W Big Beaver Rd
Troy, MI 48084-4934
Phone (248) 897-0202

National Provider Directory

National Provider Directory

Locations

2677 Elizabeth Lake Rd
Ste 203
Waterford, MI 48328
Phone (248) 682-8811

Practitioners & affiliated clinicians

Practitioners 1

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": "1678924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1932800802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 ELIZABETH LAKE RD STE 203",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2677 ELIZABETH LAKE RD STE 203",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283290",
            "telephone_number": "248-682-8811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 W Big Beaver Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480844934",
            "country_code": "US",
            "telephone_number": "248-897-0202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOW TIE ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-530-7096",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.