MICHIGAN PRIVATE DENTAL GROUP (NPI# 1902203227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902203227 |
| Entity Type | Organization |
| Organization Name | MICHIGAN PRIVATE DENTAL GROUP |
| Other Organization Name | STONERIDGE DENTAL |
| Practice Address |
27731 Jefferson Ave Saint Clair Shores MI 48081-1309 |
| Practice Telephone | 5867716440 |
| Practice Fax Number | 5867718877 |
| Mailing Telephone | 5867716440 |
| Mailing Fax Number | 5867718877 |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |
| Authorized Official Name | DR. ANTHONY R BIELKIE (PRESIDENT) |
| Authorized Official Telephone | 5867713440 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
19241 | MI | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
15810 | MI | Dental Providers |
| Other Name | Type Code |
|---|---|
| Stoneridge Dental | Doing Business As Name - Organization |
| Street Address |
27731 JEFFERSON AVE |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-1309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114046976 | Martin J Fraschetti, D.d.s., Family Dentistry P.C. | Dentist | 27731 Jefferson Ave, Saint Clair Shores, MI 48081-1309 | 2007-03-29 |
| 1558482430 | Martin J Fraschetti | Dentist | 27731 Jefferson Ave, Saint Clair Shores, MI 48081-1309 | 2007-04-02 |
| 1326167255 | Karen M Bratus | Dentist | 27731 Jefferson Ave, Saint Clair Shores, MI 48081-1309 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
| 1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
| 1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
| 1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
| 1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
| 1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
| 1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
| 1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
| 1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
| Find all providers in zip 48081 | ||||
| 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 |
|---|---|---|---|---|
| 1356951156 | Jonathan H. Jacobs, Dds, Pllc | Dentist | 24101 Greater Mack Ave, Saint Clair Shores, MI 48080-1409 | 2020-08-06 |
| 1245735620 | Joseph Michael Zylik | Dentist | 28200 Harper Ave, Saint Clair Shores, MI 48081-1684 | 2018-03-27 |
| 1235497595 | Bright Side Dental-st. Clair Shores Pllc | Dentist | 31245 Harper Ave, Saint Clair Shores, MI 48082-1401 | 2012-04-24 |
| 1053574616 | Shores Dental Reflections, Plc | Dentist | 31120 Harper Ave, Saint Clair Shores, MI 48082-1950 | 2008-07-03 |
| 1083822340 | James Francis Skoney | Dentist | 22726 Harper Ave, Saint Clair Shores, MI 48080-1823 | 2007-05-18 |
| 1457570343 | Brian James Hunt | Dentist | 24641 Jefferson Ave, Saint Clair Shores, MI 48080-1301 | 2007-04-25 |
| 1972624682 | Monica Arora Rajurs | Dentist | 29800 Harper Ave Ste 1, Saint Clair Shores, MI 48082-1655 | 2007-04-02 |
| 1114046976 | Martin J Fraschetti, D.d.s., Family Dentistry P.C. | Dentist | 27731 Jefferson Ave, Saint Clair Shores, MI 48081-1309 | 2007-03-29 |
| 1093847576 | Ronald F. Konopka | Dentist | 31850 Harper Ave, Saint Clair Shores, MI 48082-1459 | 2007-03-11 |
| 1619018652 | David Maurice Sorbo | Dentist | 30231 Jefferson Ave, Saint Clair Shores, MI 48082-1787 | 2007-02-11 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
Please comment or provide details below to improve the information on MICHIGAN PRIVATE DENTAL GROUP.
| 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.