- Practice location
- 14736 Mack Ave, Detroit, MI 48215-2524
- Phone
- 313-412-2100
- Fax
- 313-766-7734
- Last updated
- September 19, 2024
Pro Dental Mi 1 PC is a healthcare organization based in Detroit, MI. Pro Dental Mi 1 PC practices in Detroit, MI. The NPI Number for Pro Dental Mi 1 PC is 1912734286. The current practice location address for Pro Dental Mi 1 PC is 14736 Mack Ave, Detroit, MI 48215-2524 and can be reached out via phone at 313-412-2100 and via fax at 313-766-7734.
Provider Profile Details
- NPI Number
- 1912734286
- Provider Name
- Pro Dental Mi 1 PC
- Provider Entity Type
- Organization
- Address
- 14736 Mack Ave, Detroit, MI 48215-2524
- Phone Number
- 313-412-2100
- Fax Number
- 313-766-7734
- 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 Mack (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
- 14736 Mack Ave
Detroit, MI 48215-2524 - City
- Detroit
- State
- Michigan
- Zip
- 48215-2524
- Phone Number
- 313-412-2100
- Fax Number
- 313-766-7734
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
- Dentist, General Practice · 1223G0001X · Primary
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 1912734286. 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 14736 Mack Ave, Detroit, MI 48215-2524. The office can be reached at 313-412-2100 (phone) or 313-766-7734 (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 1912734286 directly on the NPPES registry website.