Edward G Kroll,DDS and Associates, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

8536 Issued in MI

Legal business name

EDWARD G KROLL,DDS AND ASSOCIATES, PC

Practice address

3704 E 8 Mile Rd
Detroit, MI 48234-1007

Phone

(313) 891-8088

Fax

(313) 891-8333

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Edward G Kroll, DDS

Title

Pesident

Phone

(313) 891-8088

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972516615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 E 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341007",
            "telephone_number": "313-891-8088",
            "fax_number": "313-891-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 E 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341007",
            "telephone_number": "313-891-8088",
            "fax_number": "313-891-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD G KROLL,DDS AND ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KROLL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PESIDENT",
        "authorized_official_telephone_number": "313-891-8088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "8536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4015745",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alandis De'Ersula Edmonds
• Khalilah Edmondson
• Claudia Nicole Edmonson, SST, HSA
• Educating U4 Life CDC
• Edward a Clay MD PC
• Edward Roberts PLLC
• Edward Simmons Massage Therapists LLC
• Alicia Edwards, LLBSW
• Anthony Edwards, LMSW
• Belinda Fay Edwards

• Dental Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Dental Clinic/Center in Michigan

• 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.