DR. MARIO ENDIAKOV DMD
NPI 1194217166
Dentist in Detroit, MI

Q: What is Mario Endiakov's NPI number?

The NPI number for Mario Endiakov is 1194217166. It was assigned to this individual provider in the NPPES registry on June 5, 2018.

Q: What is Mario Endiakov's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Mario Endiakov was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.

Active since June 05, 2018

13874 GRAND RIVER AVE, DETROIT, MI 48227(313) 834-4900 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 2, 2025, Jul 6, 2024, Jun 28, 2024 and 2 more (5 updates tracked since 2022).

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About Dr. Mario Endiakov Dmd NPPES

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

DR. MARIO ENDIAKOV DMD (NPI 1194217166) is an individual dentist in Detroit, Michigan, licensed in Michigan (2901602634) and active in the NPI registry since June 2018. He maintains a secondary practice location in Detroit.

NPPES Registry Identity

NPI1194217166

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. MARIO ENDIAKOVCredential: DMD

Location Address13874 GRAND RIVER AVEDetroit, MI 48227-3123

Mailing Address13874 Grand River AveDetroit, MI 48227-3123 · (313) 834-4900

Phone(313) 834-4900

Sole ProprietorYes

Enumeration DateJune 5, 2018

Last NPPES UpdateSeptember 2, 20255 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2025

✔ NPI 1194217166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in MI · 2901602634✔ Licensed in IL · 019031843

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 2901602634 (MI)

13874 GRAND RIVER AVE, Detroit, MI 48227

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Secondary Practice Location 1

Location 12700 Martin Luther King Jr BlvdDetroit, MI 48208-2576 · Phone (313) 494-6700

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Other Providers at the Same Location NPPES 13

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

MARISOL ANDREA GEMMA SEGUEL ROA DDS

Dentist (General Practice)