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LIVONIA LASER DENTISTRY NPI 1811476955


NPI Information

NPI: 1811476955
Provider Name: LIVONIA LASER DENTISTRY
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
31632 SCHOOLCRAFT RD
LIVONIA, MI
ZIP 48150
Phone: (734) 425-6920
Get Directions

LIVONIA LASER DENTISTRY is a general practice dentist in Livonia, MI. The provider is 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. LIVONIA LASER DENTISTRY NPI is 1811476955. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

31632 SCHOOLCRAFT RD
LIVONIA, MI
ZIP 48150-819
Phone: (734) 425-6920
Fax: (734) 425-1541

The provider's authorized official is Fady Mansour .
The authorized official title is Admin and has the following contact phone number (734) 425-6920.

The enumeration date for this NPI number is 8/9/2018 and was last updated on 8/9/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice2901017025MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
113167481MEDICAIDMICHIGAN
22901017025OTHERMICHIGANMICHIGAN PROFESSIONAL LICENSE - DENTISY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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