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GREAT LAKES DENTAL GROUP PLLC
NPI 1053199141
Dentist - Periodontics in Royal Oak, MI

Active since September 19, 2023
4251 COOLIDGE HWY, ROYAL OAK, MI 48073(248) 547-3700 Get Directions Write a Review

NPPES record last updated: September 19, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Great Lakes Dental Group Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES DENTAL GROUP PLLC (NPI 1053199141), doing business as Dental Implant Center Of Royal Oak, is a healthcare organization registered as a periodontics in Royal Oak, Michigan and active in the NPI registry since September 2023. The organization lists Delia Danowski, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1053199141
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameGREAT LAKES DENTAL GROUP PLLC
Location Address4251 COOLIDGE HWYRoyal Oak, MI 48073-1639
Mailing Address4251 Coolidge HwyRoyal Oak, MI 48073-1639 · (248) 547-3700 · Fax (248) 547-2297
Phone(248) 547-3700
Organization SubpartNo
Authorized OfficialDelia DanowskiOffice Manager · (248) 547-3700
Enumeration DateSeptember 19, 2023
NPPES CertifiedSeptember 19, 2023
✔ NPI 1053199141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Also ListedDentist · ProsthodonticsTaxonomy 1223P0700X
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X
4251 COOLIDGE HWY, Royal Oak, MI 48073
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Other Names 1

Doing Business AsDental Implant Center Of Royal Oak

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LEEN MUSHARBASH DDS, MS, FACP
Dentist (Prosthodontics)
4251 COOLIDGE HWY
ROYAL OAK, MI 48073
Oakland County (267) 283-8101
DR. CHADY AHMED ELHAGE D.D.S., M.S.
Dentist (Prosthodontics)
4251 COOLIDGE HWY
ROYAL OAK, MI 48073
Oakland County (248) 547-3700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Dental Group PLLC's NPI number?

The NPI number for Great Lakes Dental Group PLLC is 1053199141. It was assigned to this organization in the NPPES registry on September 19, 2023. The provider is doing business as Dental Implant Center of Royal Oak.

Where is Great Lakes Dental Group PLLC located?

Great Lakes Dental Group PLLC is located at 4251 Coolidge Hwy, Royal Oak, MI 48073. The listed phone number is (248) 547-3700.

What is Great Lakes Dental Group PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Great Lakes Dental Group PLLC was last updated on September 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.