Cobblestone Ridge Dentistry

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

COBBLESTONE RIDGE DENTISTRY

Practice address

16800 24 Mile Rd Ste 5
Macomb, MI 48042-2990

Phone

(586) 781-2757

NPI assigned

Nov 1, 2022

Last updated

Nov 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Teno, DDSNPI 1871672055

Title

Dentist

Phone

(586) 781-2757

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey Richard Teno, DDS

  • Dentist
  • Macomb, MI
  • NPI 1871672055
  NPD Authorized official

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1982311767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 24 MILE RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480422990",
            "telephone_number": "586-612-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16800 24 MILE RD STE 5",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480422990",
            "telephone_number": "586-781-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBBLESTONE RIDGE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "TENO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "586-781-2757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Macomb, MI
• Providers in Macomb, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.