Mack Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901017752 Issued in MI

Legal business name

MACK DENTAL CENTER

Doing business as

Mack Dental Center

Practice address

20640 Vernier Rd
Harper Woods, MI 48225

Phone

(313) 343-6650

Fax

(888) 978-5270

NPI assigned

Oct 10, 2008

Organization subpart

No

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

Authorized official

Name

Mr. George Georges Chabiaa, DDS

Title

President

Phone

(313) 269-4564

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mack Dental Center Doing business as

Locations

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1982855706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20640 VERNIER RD",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "48225",
            "telephone_number": "313-269-4564",
            "fax_number": "888-978-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20640 VERNIER RD",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "48225",
            "telephone_number": "313-343-6650",
            "fax_number": "888-978-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "CHABIAA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "GEORGES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-269-4564",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4303938",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mack Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Harper Woods, MI
• Providers in Harper Woods, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.