SMILE FRESH DETROIT PC (NPI# 1164963401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164963401 |
| Entity Type | Organization |
| Organization Name | SMILE FRESH DETROIT PC |
| Other Organization Name | SMILE FRESH DENTAL |
| Practice Address |
7230 Gratiot Avenue Detroit MI 48213 |
| Mailing Address |
1507 Threadneedle St Bloomfield Hills MI 48304-1020 |
| Practice Telephone | 2488956987 |
| Mailing Telephone | 2488956987 |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |
| Authorized Official Name | FAUZI MOHAMMED RAZIUDDIN (OFFICE MANAGER) |
| Authorized Official Telephone | 2488956987 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2901021727 | MI | Dental Providers |
| Other Name | Type Code |
|---|---|
| SMILE FRESH DENTAL | Doing Business As Name - Organization |
| Street Address |
7230 GRATIOT AVENUE |
| City | DETROIT |
| State | MI |
| Zip Code | 48213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215540430 | Sheronda Lanetta Blackmon | Licensed Practical Nurse | 13929 Harper Ave., Detroit, MI 48213 | 2020-08-27 |
| 1073049144 | Cheryl Williams | Community Health Worker | 13929 Chalmers Ave., Detroit, MI 48213 | 2017-05-10 |
| 1255887899 | Jay Washington | Behavioral Analyst | 9146 Haper, Detroit, MI 48213 | 2016-09-01 |
| 1396129532 | Sarietha King | Home Health | 14639 Manistique, Detroit, MI 48213 | 2015-07-17 |
| 1366823197 | Royal Treatment Mental Health Systems, LLC | Counselor | 5555 Corner Avenue, Detroit, MI 48213 | 2015-06-17 |
| 1477956779 | Monique Powell | Student in an Organized Health Care Education/Training Program | 5801 Lakeview S.t, Detroit, MI 48213 | 2014-09-30 |
| 1629339163 | Samuel Joseph Farmer | Counselor | 10100 Harper Ave., Detroit, MI 48213 | 2012-05-31 |
| 1609164755 | Vernon Keith Johnson | Social Worker | 20203 Kelly Road, Detroit, MI 48213 | 2011-07-11 |
| 1023312790 | Davenport Quality Home Care LLC | Home Health | 5027 Maxwell, Detroit, MI 48213 | 2011-01-10 |
| 1225368301 | William W. Martin, Md PC | Clinic/Center | 5575 Conner, Suite 208, Detroit, MI 48213 | 2010-01-12 |
| Find all providers in zip 48213 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528678687 | Elmwood Park Dental | Dentist | 1547 E Lafayette St, Detroit, MI 48207-2958 | 2020-08-04 |
| 1205452786 | Daniel Galvez | Dentist | 200 Riverfront Dr Apt 20f, Detroit, MI 48226-7598 | 2020-06-22 |
| 1669947107 | Diamond Smiles Dentistry, PC | Dentist | 13334 E Jefferson Ave, Detroit, MI 48215-2719 | 2018-10-11 |
| 1053802629 | Hussein Daher | Dentist | 6061 W Vernor Hwy Ste 1, Detroit, MI 48209-2085 | 2018-05-19 |
| 1497278287 | Kamil Abraham | Dentist | 24366 Grand River Ave Ste 111, Detroit, MI 48219-3098 | 2017-07-24 |
| 1326561887 | Nicholas Dipilla | Dentist | 1 Woodward Ave Ste 1625, Detroit, MI 48226-3422 | 2017-07-17 |
| 1164967469 | Fady Sarkees | Dentist | 21427 Grand River Ave, Detroit, MI 48219-3896 | 2016-12-23 |
| 1538523477 | Charnia Hall | Dentist | 4272 Saint Antoine St, Detroit, MI 48201-2108 | 2016-04-06 |
| 1093178378 | Florence Koloko | Dentist | 250 E Harbortown Dr Apt 608, Detroit, MI 48207-5010 | 2016-04-03 |
| 1972977429 | Conant Garden Dental Center Dds PC | Dentist | 2430 E Seven Mile, Suite 6, Detroit, MI 48234 | 2015-11-20 |
| Find all providers in DETROIT | ||||
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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.