CHILDRENS DENTAL CARE OF DETROIT (NPI# 1104482439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104482439 |
Entity Type | Organization |
Organization Name | CHILDRENS DENTAL CARE OF DETROIT |
Other Organization Name | CHILDREN'S DENTAL CARE OF DETROIT |
Practice Address |
430 Mack Ave Detroit MI 48201-2136 |
Practice Telephone | 3132626059 |
Practice Fax Number | 3132626331 |
Mailing Telephone | 3132626059 |
Mailing Fax Number | 3132626331 |
Enumeration Date | 2019-05-13 |
Last Update Date | 2019-06-11 |
Authorized Official Name | HASSAN OUEIS (OWNER) |
Authorized Official Telephone | 3132626059 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 1386813244 | 05 |
Other Name | Type Code |
---|---|
Children's Dental Care of Detroit | Former Legal Business Name - Organization |
Street Address |
430 MACK AVE |
City | DETROIT |
State | MI |
Zip Code | 48201-2136 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801863998 | Medical Management PC | Family Medicine | 430 Mack Ave, Detroit, MI 48201-2136 | 2006-03-07 |
1104376771 | Darnell Kaigler Pllc | Dentist | 430 Mack Ave, Detroit, MI 48201-2136 | 2016-10-07 |
1821542010 | Arianne Sophia Swanson | Dentist | 430 Mack Ave, Detroit, MI 48201-2136 | 2016-08-05 |
1235437807 | Rio Detroit Inc | Pharmacy | 430 Mack Ave, Detroit, MI 48201-2136 | 2011-03-07 |
1588971980 | Mack Medical Management LLC | Specialist | 430 Mack Ave, Detroit, MI 48201-2136 | 2010-09-07 |
1205148616 | Renaissance Medical Center Pllc | Medical Genetics, Ph.D. Medical Genetics | 430 Mack Ave, Detroit, MI 48201-2136 | 2010-07-14 |
1861668089 | Anant Inc | Pharmacy | 430 Mack Ave, Detroit, MI 48201-2136 | 2008-05-07 |
1295908069 | Dmxrx Ltd | Pharmacy | 430 Mack Ave, Detroit, MI 48201-2136 | 2008-04-11 |
1205008125 | Ruben Taguiam Benito | Legal Medicine | 430 Mack Ave, Suite B, Detroit, MI 48201 | 2008-04-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
Find all providers in zip 48201 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669722856 | Richard Iain Tann | Dentist | 79 W Alexandrine St Fl 3, Detroit, MI 48201-2015 | 2012-09-14 |
1093846974 | Mona Rizk Ibrahim | Dentist | Detroit Health Dept. - Herman Kiefer Health Complex, 1151 Taylor Street, 7th Floor Pediatric Dental Clinic, Detroit, MI 48202-1732 | 2007-03-09 |
1801846985 | James Patrick Stenger | Dentist | 79 W Alexandrine St, 3rd Floor, Detroit, MI 48201-2015 | 2006-05-11 |
1104307651 | Fahad Siddiqui | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2018-08-23 |
1992165930 | Rehab Alabduljabbar | Dentist | 2700 Mlk Jr Blvd, Detroit, MI 48208-2576 | 2016-03-03 |
1851751150 | Thomas Veraldi, Dmd Residency and Hospital Practice, PC | Dentist | 79 W Alexandrine St, 3rd Flr, Detroit, MI 48201-2015 | 2016-02-29 |
1215215298 | Deliver Dental Solutions, Inc. | Dentist | 79 W Alexandrine St, 3rd Floor, Detroit, MI 48201-2015 | 2011-07-25 |
1821304858 | Kristen Charlene Ponichter | Dentist | 7633 E Jefferson Ave, Detroit, MI 48214-3730 | 2010-08-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033717558 | Discover Smiles Pediatric Dentistry | Dentist | 2277 Science Pkwy Ste 2, Okemos, MI 48864-2551 | 2020-10-16 |
1740898873 | Megan E Stowers Dds Ms Plc | Dentist | 7459 Middlebelt Rd Ste 1, West Bloomfield, MI 48322-4184 | 2020-07-15 |
1447884069 | Jocelyn M. Robelli Dds, Ms, Pllc | Dentist | 18245 E 10 Mile Rd Ste 110, Roseville, MI 48066-5807 | 2020-02-24 |
1457914038 | Mitten Kids Dentistry Caledonia Plc | Dentist | 6477 Cherry Meadow Dr Se Ste 4, Caledonia, MI 49316-7351 | 2019-04-18 |
1780143982 | Childrens Dental Specialists of Hazel Park Pllc | Dentist | 22241 John R Rd, Hazel Park, MI 48030-1716 | 2019-03-18 |
1487128120 | Dental Group Associates PC | Dentist | 4505 Cascade Rd Se # B, Grand Rapids, MI 49546-8381 | 2019-01-16 |
1184194433 | Pediatric Dental Specialists of West Michigan | Dentist | 2155 E Paris Ave Se Ste 120, Grand Rapids, MI 49546-6142 | 2018-11-29 |
1811465990 | Kingma Pediatric Dentistry Pllc | Dentist | 1179 E Paris Ave Se Ste 130, Grand Rapids, MI 49546-3682 | 2018-11-07 |
1407322548 | Great Lakes Bay Pediatric Dentistry, Plc | Dentist | 5605 Colony Dr N Ste 2, Saginaw, MI 48638-7187 | 2018-10-16 |
1063987725 | Little Red Pediatric Dentistry, Plc | Dentist | 12723 N Bellwood Dr Ste 20, Holland, MI 49424-7275 | 2018-10-09 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.