Organization Active NPI

Dean Clinic, P.C.

  • Primary Care Clinic/Center
  • Detroit, MI
National Provider Identifier
1942357959
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
DEAN CLINIC, P.C.
Practice address
4140 E 8 Mile Rd
Detroit, MI 48234-1014
Phone
(313) 366-9502
Fax
(313) 366-9503
NPI assigned
Jan 4, 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
Dr. Roger Stanley Harris, D.O.
Title
President
Phone
(313) 366-9502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MI Primary

Addresses

Primary practice location

4140 E 8 Mile Rd
Detroit, MI 48234-1014

Mailing address

4140 E 8 Mile Rd
Detroit, MI 48234-1014
Phone (313) 366-9502

Other identifiers 1

IdentifierTypeStateIssuer
1371362MedicaidMI

National Provider Directory

National Provider Directory

Locations

4140 E 8 Mile Rd
Detroit, MI 48234
Phone (313) 366-9502

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942357959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 E 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341014",
            "telephone_number": "313-366-9502",
            "fax_number": "313-366-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 E 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341014",
            "telephone_number": "313-366-9502",
            "fax_number": "313-366-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-366-9502",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1371362",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, 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.