- Practice location
- 16201 Ford RD Ste 115, Dearborn, MI 48126-2876
- Phone
- 313-451-8304
- Fax
- 313-789-7993
- Last updated
- September 19, 2024
Pro Dental Mi 1 PC is a healthcare organization based in Dearborn, MI. Pro Dental Mi 1 PC practices in Dearborn, MI. The NPI Number for Pro Dental Mi 1 PC is 1669209938. The current practice location address for Pro Dental Mi 1 PC is 16201 Ford RD Ste 115, Dearborn, MI 48126-2876 and can be reached out via phone at 313-451-8304 and via fax at 313-789-7993.
Provider Profile Details
- NPI Number
- 1669209938
- Provider Name
- Pro Dental Mi 1 PC
- Provider Entity Type
- Organization
- Address
- 16201 Ford RD Ste 115, Dearborn, MI 48126-2876
- Phone Number
- 313-451-8304
- Fax Number
- 313-789-7993
- Primary Taxonomy
- Dentist · 122300000X
- Organization Subpart
- No
- Authorized Official
- Simone Wilson-Adeleke, MPA-PPA · Director Of Credentialing · 732-731-8398
- Other Names
- Destiny Dental Of Dearborn (Doing Business As)
- Provider Enumeration Date
- September 19, 2024
- Last Update Date
- September 19, 2024
- Certification Date
- September 18, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 16201 Ford RD Ste 115
Dearborn, MI 48126-2876 - City
- Dearborn
- State
- Michigan
- Zip
- 48126-2876
- Phone Number
- 313-451-8304
- Fax Number
- 313-789-7993
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
- 732-731-8398
License Information
- Taxonomy (1)
- Dentist · 122300000X · Primary
- Taxonomy (2)
- Dentist, General Practice · 1223G0001X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 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 1669209938. 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 (code 122300000X).
Where does Pro Dental Mi 1 PC practice?
The practice location is 16201 Ford RD Ste 115, Dearborn, MI 48126-2876. The office can be reached at 313-451-8304 (phone) or 313-789-7993 (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 1669209938 directly on the NPPES registry website.