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WAYNE STATE UNIVERSITY PHYSICIAN GROUP
NPI 1275572075
Dentist - Prosthodontics in Detroit, MI

Active since June 06, 2006
4201 SAINT ANTOINE ST, SUITE 5G, DETROIT, MI 48201(313) 745-4095(313) 577-8555 Get Directions Write a Review

NPPES record last updated: October 26, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 26, 2016, Feb 16, 2016 (2 updates tracked since 2016).

About Wayne State University Physician Group NPPES

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

WAYNE STATE UNIVERSITY PHYSICIAN GROUP (NPI 1275572075) is a healthcare organization registered as a prosthodontics in Detroit, Michigan and active in the NPI registry since June 2006. The organization lists Jeffery P Kohlitz, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1275572075
Entity TypeOrganization
Primary Taxonomy1223P0700X
Legal Business NameUNIVERSITY PHYSICIAN GROUP
Location Address4201 SAINT ANTOINE ST, SUITE 5GDetroit, MI 48201-2153
Mailing Address1560 E. Maple Rd., Suite 400-credentialing Dept.Troy, MI 48083-1138 · (248) 581-5973 · Fax (248) 581-5640
Phone(313) 745-4095
Fax(313) 577-8555
Organization SubpartNo
Authorized OfficialJeffery P KohlitzChief Financial Officer · (248) 581-5930
Enumeration DateJune 6, 2006
Last NPPES UpdateOctober 26, 20162 updates tracked since enumeration
✔ NPI 1275572075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · ProsthodonticsDental Providers
Taxonomy Code1223P0700X
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
4201 SAINT ANTOINE ST, Detroit, MI 48201
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Other Names 1

Doing Business AsWayne State University Physician Group

Other Identifiers 2

Other0P32160MI · Medicare Group # - Dds
Medicare PIN0P32160MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

DR. ZOHA NIZAMI
Pediatrics (Pediatric Emergency Medicine)
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146
DR. PUJA LAROIA DO
Anesthesiology
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146
ELIZABETH ANNE RANELLA CRNA
Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (952) 442-9770
GERARD LANCASTER MD
Orthopaedic Surgery
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-3000
SARAH ZHANG
Emergency Medicine
4201 SAINT ANTOINE ST, UHC-6G
DETROIT, MI 48201
Wayne County (313) 993-2529
DAVID BURKHOLDER
Student in an Organized Health Care Education/Training Program
4201 SAINT ANTOINE ST, 6G UHC
DETROIT, MI 48201
Wayne County (313) 993-2530
DR. DANIEL RAY CAVAZOS MD
Orthopaedic Surgery
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-3000
WAHAJUDDIN MOHAMMAD DO
Student in an Organized Health Care Education/Training Program
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Wayne County (313) 745-5146

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 University Physician Group's NPI number?

The NPI number for University Physician Group is 1275572075. It was assigned to this organization in the NPPES registry on June 6, 2006. The provider is doing business as Wayne State University Physician Group.

Where is University Physician Group located?

University Physician Group is located at 4201 Saint Antoine St Suite 5G, Detroit, MI 48201. The listed phone number is (313) 745-4095.

What is University Physician Group's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

When was this NPI record last updated?

The NPPES record for University Physician Group was last updated on October 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.