NPIMap

Organization Active NPI

Orchard Maple Family Dental, PLLC

  • General Practice Dentistry
  • West Bloomfield, MI
National Provider Identifier
1992097497
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11170 Issued in MI
Legal business name
ORCHARD MAPLE FAMILY DENTAL, PLLC
Practice address
6280 Orchard Lake Rd
West Bloomfield, MI 48322-2321
Phone
(248) 851-2876
Fax
(248) 851-1669
NPI assigned
May 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Authorized official

Name
William Henry Woodruff Jr., D.D.S
Title
President
Phone
(248) 851-2876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 11170 MI Primary

Addresses

Primary practice location

6280 Orchard Lake Rd
West Bloomfield, MI 48322-2321

Mailing address

6280 Orchard Lake Rd
West Bloomfield, MI 48322-2321
Phone (248) 851-2876

Other identifiers 1

IdentifierTypeStateIssuer
3482290MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304380800000",
    "number": "1992097497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6280 ORCHARD LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222321",
            "telephone_number": "248-851-2876",
            "fax_number": "248-851-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6280 ORCHARD LAKE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222321",
            "telephone_number": "248-851-2876",
            "fax_number": "248-851-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD MAPLE FAMILY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-851-2876",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3482290",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; 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.