Active NPIOrganization

Pro Dental Mi 1 PC

Dentist, General Practice in Wyoming, Michigan

NPI Number1326875600
Practice location
1124 28TH St SW, Wyoming, MI 49509-2855
Fax
616-530-9959
Last updated
September 19, 2024

Pro Dental Mi 1 PC is a healthcare organization based in Wyoming, MI. Pro Dental Mi 1 PC practices in Wyoming, MI. The NPI Number for Pro Dental Mi 1 PC is 1326875600. The current practice location address for Pro Dental Mi 1 PC is 1124 28TH St SW, Wyoming, MI 49509-2855 and can be reached out via phone at 616-530-9900 and via fax at 616-530-9959.

Provider Profile Details

NPI Number
1326875600
Provider Name
Pro Dental Mi 1 PC
Provider Entity Type
Organization
Address
1124 28TH St SW, Wyoming, MI 49509-2855
Phone Number
616-530-9900
Fax Number
616-530-9959
Primary Taxonomy
Dentist, General Practice · 1223G0001X
Organization Subpart
No
Authorized Official
Simone Wilson-Adeleke, MPA-PPA · Director Of Credentialing · 732-731-8398
Other Names
Destiny Dental Of Wyoming (Doing Business As)
Provider Enumeration Date
September 19, 2024
Last Update Date
September 19, 2024
Certification Date
September 19, 2024
NPI Status
Active

Provider Business Practice Location Address Details

Address
1124 28TH St SW
Wyoming, MI 49509-2855
Zip
49509-2855
Phone Number
616-530-9900
Fax Number
616-530-9959
Wyoming, MI 49509Get directions →

Provider Business Mailing Address Details

Address
10 Woodbridge Center Dr Ste 520
Woodbridge, NJ 07095-1152
City
Woodbridge
State
NJ
Zip
07095-1152
Phone Number
848-326-8840

License Information

Taxonomy
Dentist, General Practice · 1223G0001X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Pro Dental Mi 1 PC?

The NPI number of Pro Dental Mi 1 PC is 1326875600. It was assigned on September 19, 2024 and is currently active in the NPPES registry.

What is the specialty of Pro Dental Mi 1 PC?

Pro Dental Mi 1 PC is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X).

Where does Pro Dental Mi 1 PC practice?

The practice location is 1124 28TH St SW, Wyoming, MI 49509-2855. The office can be reached at 616-530-9900 (phone) or 616-530-9959 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1326875600 directly on the NPPES registry website.

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