DDS-TAPESTRY (NPI# 1629510482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629510482 |
| Entity Type | Organization |
| Organization Name | DDS-TAPESTRY |
| Practice Address |
7633 E Jefferson Ave Ste 200 Detroit MI 48214-3730 |
| Mailing Address |
7310 Woodward Ave Ste 400 Detroit MI 48202-3165 |
| Practice Telephone | 3138332895 |
| Practice Fax Number | 3132440661 |
| Mailing Telephone | 3135762554 |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-12-13 |
| Authorized Official Name | DR. THOMAS ROSE (OWNER) |
| Authorized Official Telephone | 2485346769 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
7633 E JEFFERSON AVE STE 200 |
| City | DETROIT |
| State | MI |
| Zip Code | 48214-3730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922097542 | Steven P Hadesman | Internal Medicine | 7633 E Jefferson Ave, Suite 290, Detroit, MI 48214-3730 | 2005-10-17 |
| 1336675727 | Nicholas Joseph Thomas | Student in an Organized Health Care Education/Training Program | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2017-05-04 |
| 1144677501 | Princess Elhosary | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2016-05-16 |
| 1427419688 | Ashley D'agostini | Student in an Organized Health Care Education/Training Program | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2016-03-16 |
| 1912383928 | Dearborn Podiatry Clinic Pllc | Podiatrist | 7633 E Jefferson Ave, Suite 250, Detroit, MI 48214-3730 | 2015-08-03 |
| 1487037610 | Samantha Dubin | Student in an Organized Health Care Education/Training Program | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2015-07-07 |
| 1023415288 | Bazzi Podiatry | Podiatrist | 7633 E Jefferson Ave, Suite 250, Detroit, MI 48214-3730 | 2014-12-03 |
| 1164829438 | David Scott Coviak | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-12-02 |
| 1124428198 | Matthew Cannavo | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-08-27 |
| 1821401449 | Brandon Duncan | Student in an Organized Health Care Education/Training Program | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376042325 | Tamara Wesley | Registered Nurse | 9000 E. Jefferson Apt 28-14, Detroit, MI 48214 | 2018-02-06 |
| 1720534381 | Birth Beautiful Detroit | Clinic/Center | 1086 Baldwin, Detroit, MI 48214 | 2016-09-01 |
| 1225402886 | Steven Doyle Whatley I | Counselor | 1423 Field Ave., Adult Well Being Services, Detroit, MI 48214 | 2015-11-19 |
| 1255587945 | Andrew Avery | Internal Medicine | 7733 East Jefferson Ave, Detroit, MI 48214 | 2008-08-13 |
| 1639330210 | Nicole Lashawn Greene | Specialist | 4533 St Clair St, Detroit, MI 48214 | 2008-06-17 |
| 1629299433 | Alan R Faber Jr. | Dentist | 8191 E Jefferson Ave, Detroit, MI 48214 | 2007-05-01 |
| 1518188598 | Mary F Bridges | Psychiatry & Neurology | 8120 East Jefferson #3l, Detroit, MI 48214 | 2007-05-01 |
| 1053439737 | Geraldine Etella Davis | Counselor | 3840 Fairview St., Detroit, MI 48214 | 2007-03-27 |
| 1639203482 | Detroit-macomb Hospital Corporation | Advanced Practice Midwife | 7815 E. Jefferson, Detroit, MI 48214 | 2007-03-15 |
| 1033275441 | Anesha Amor Rouse | Physical Therapy Assistant | 7633 E. Jefferson Ave, Suite 170, Detroit, MI 48214 | 2006-12-29 |
| Find all providers in zip 48214 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477903904 | Abed Yakan | Dentist | 2700 Martin Luther King Jr. Blvd., 358, Detroit, MI 48208-2576 | 2016-06-15 |
| 1932308566 | Haissam A Kanaan | Dentist | Oral and Maxillofacial Surgery - Uhc 2f, 4201 St. Antoine Street, Detroit, MI 48201 | 2007-07-13 |
| 1912035817 | Suzanne Pasternak | Dentist | 4201 Saint Antoine St Ste 2f, Detroit, MI 48201-2153 | 2007-03-01 |
| 1619479763 | Amir Allhaji | Dentist | 4201 Saint Antoine St, Detroit, MI 48201 | 2018-03-05 |
| 1306380654 | Deepthy Nair | Dentist | 2700 Martin Luther King Jr Blvd, Department of Oral and Maxillofacial Surgery, Detroit, MI 48208-2576 | 2016-12-06 |
| 1164829438 | David Scott Coviak | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-12-02 |
| 1124428198 | Matthew Cannavo | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2014-08-27 |
| 1023442399 | Ibrahim El Deeb Zakhary | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2013-08-22 |
| 1881971398 | Helena Michelle Perez | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208-2576 | 2011-11-11 |
| 1053608752 | Kyle Klooster | Dentist | 7633 E Jefferson Ave, Suite 70, Detroit, MI 48214-3730 | 2011-07-01 |
| 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.