CHILDRENS DENTAL CARE OF DETROIT


Address: 430 Mack Ave, Detroit, MI 48201-2136
Phone: 3132626059

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI 1386813244 05

Other Provider/Organization Names

Other Name Type Code
Children's Dental Care of Detroit Former Legal Business Name - Organization

Office Location

Street Address 430 MACK AVE
City DETROIT
State MI
Zip Code 48201-2136

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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

Competitor

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City DETROIT
Zip Code 48201

Improve Information

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Dataset Information

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.

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