GREAT LAKES FAMILY DENTAL GROUP-LIVONIA, P.C. (NPI# 1497077630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497077630 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES FAMILY DENTAL GROUP-LIVONIA, P.C. |
| Practice Address |
16160 Middlebelt Rd Livonia MI 48154-3338 |
| Mailing Address |
G3222 Beecher Rd Flint MI 48532-3614 |
| Practice Telephone | 7342619696 |
| Mailing Telephone | 8102303245 |
| Mailing Fax Number | 8102303229 |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2010-02-15 |
| Authorized Official Name | DR. C PATRICK GRAY (OWNER/PRESIDENT) |
| Authorized Official Telephone | 8107320200 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1223S0112X | MI | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
122300000X | MI | Dental Providers |
| Street Address |
16160 MIDDLEBELT RD |
| City | LIVONIA |
| State | MI |
| Zip Code | 48154-3338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215002456 | Karen Bartos | Dentist | 16160 Middlebelt Rd, Livonia, MI 48154-3338 | 2006-11-22 |
| 1497315998 | Thomas Roger Lemonds | Dentist | 16160 Middlebelt Rd, Livonia, MI 48154 | 2019-06-17 |
| 1083107569 | Morgan Taylor Semaan | Dentist | 16160 Middlebelt Rd, Livonia, MI 48154-3338 | 2018-06-11 |
| 1669820528 | Andrew Namou | Dentist | 16160 Middlebelt Rd, Livonia, MI 48154-3338 | 2016-06-01 |
| 1073688156 | Michael Pardonnet | Dentist | 16160 Middlebelt Rd, Livonia, MI 48154-3338 | 2006-11-22 |
| 1952476046 | Michael Drzewicki | Dentist | 16160 Middlebelt Rd, Livonia, MI 48154-3338 | 2006-11-22 |
| 1518032606 | Robin Schumacher | Dentist | 16160 Middlebelt Rd, Livonia, MI 48154-3338 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699386227 | Iha Health Service Corporation | Durable Medical Equipment & Medical Supplies | Iha Associates In Podiatry, 14555 Levan Road Suite 116, Livonia, MI 48154 | 2020-08-17 |
| 1972130136 | Cameron Strong | Student in an Organized Health Care Education/Training Program | St. Mary Mercy Hospital, 36475 Five Mile Road, Livonia, MI 48154 | 2020-03-26 |
| 1447894019 | Nova Pharmacy | Pharmacy | 15140 Levan Rd, Suite 40, Livonia, MI 48154 | 2019-11-06 |
| 1356992242 | Milly Baydoun | Registered Nurse | 36650 Five Mile Rd Ste 106, Livonia, MI 48154 | 2019-09-23 |
| 1861059396 | Align Family Chiropractic LLC | Clinic/Center | 19047 Middlebelt Rd, Livonia, MI 48154 | 2019-05-21 |
| 1619442159 | Ashley Vaduva | Counselor | 37677 Professional Center Dr Ste 110c, Livonia, MI 48154 | 2018-10-11 |
| 1245719434 | Myron Rubin Dds PC | Dentist | 15357 Frmington Rd, Livonia, MI 48154 | 2018-08-09 |
| 1720578636 | New Beginnings Addiction & Counseling Services | Counselor | 27677 Professional Center Drive Suite 135, Livonia, MI 48154 | 2018-05-16 |
| 1831693670 | Robust Rehab Services, Inc. | Occupational Therapist | 32854 5 Mile Rd, Livonia, MI 48154 | 2018-03-19 |
| 1184139644 | Nova Pharmacy LLC | Pharmacy | 15140 Levan Rd Suite 40, Livonia, MI 48154 | 2017-12-06 |
| Find all providers in zip 48154 | ||||
| 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 |
|---|---|---|---|---|
| 1265047641 | Michigan Implant Dental Center | Dentist | 28701 Plymouth Rd Ste B, Livonia, MI 48150-2421 | 2020-09-11 |
| 1881210573 | John Patrick Duerr | Dentist | 18618 Middlebelt Rd Ste 105, Livonia, MI 48152-3586 | 2020-06-18 |
| 1245719434 | Myron Rubin Dds PC | Dentist | 15357 Frmington Rd, Livonia, MI 48154 | 2018-08-09 |
| 1649763368 | Brian Kelly | Dentist | 9134 Middlebelt Rd, Livonia, MI 48150-4035 | 2018-06-07 |
| 1972975837 | Majestic Dentist Pllc | Dentist | 32788 Five Mile Rd, Livonia, MI 48154-6001 | 2015-10-30 |
| 1760852735 | Vmlp Liv Plc | Dentist | 13417 Middlebelt Rd, Livonia, MI 48150-2229 | 2015-10-02 |
| 1811300130 | Christine Eskander | Dentist | 14600 Farmington Rd Ste 103, Livonia, MI 48154-5431 | 2014-06-04 |
| 1336494954 | Lindsay Ann Holman | Dentist | 32280 Five Mile Rd, Livonia, MI 48154-6112 | 2012-07-19 |
| 1790004711 | Thomas Stephen Schwagle | Dentist | 16232 Fairlane Dr, Livonia, MI 48154-2568 | 2010-06-01 |
| 1154653319 | Qualitas Dental Group, PC | Dentist | 17199 N Laurel Park Dr, Suite 200, Livonia, MI 48152-2683 | 2010-02-12 |
| Find all providers in LIVONIA | ||||
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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.