Individual provider Active NPI

Reem Riadh Israel, DDS

  • Dentist
  • Berkley, MI
National Provider Identifier
1952919631
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901600551 Issued in MI
Practice address
2645 Coolidge Hwy
Berkley, MI 48072-1554
Phone
(248) 541-5510
NPI assigned
Jul 17, 2020
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901600551 MI Primary

Addresses

Primary practice location

2645 Coolidge Hwy
Berkley, MI 48072-1554

Mailing address

27312 Hampden St
Madison Heights, MI 48071-3114
Phone (248) 631-9841

Other practice location 1

20630 Vernier Rd
Harper Woods, MI 48225-1415
Phone (313) 884-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901600551MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
TK Investment Harper Woods CurrentSince Aug 2, 2020 Accepting new patients
Berkley Family Dental PLLC CurrentSince Aug 15, 2021 Accepting new patients
Berkley Dental PC CurrentSince Aug 15, 2021 Accepting new patients
Waterford Family Dental PLLC PastSince Sep 1, 2020 Accepting new patients

Locations

2645 Coolidge Hwy
Berkley, MI 48072
Phone (248) 541-5510

20630 Vernier Rd
Harper Woods, MI 48225
Phone (313) 884-0040

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1952919631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27312 HAMPDEN ST",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713114",
            "telephone_number": "248-631-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721554",
            "telephone_number": "248-541-5510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20630 Vernier Rd",
            "address_purpose": "LOCATION",
            "city": "Harper Woods",
            "state": "MI",
            "postal_code": "482251415",
            "country_code": "US",
            "telephone_number": "313-884-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "REEM",
        "middle_name": "RIADH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

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