WATERFORD KIDS DENTAL CLUB, PLLC
NPI 1689224818
Dentist - General Practice in Waterford, MI
- Organization
- Dentist
- General Practice
- CLIA Number: 23D0372415
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-31-2026
About WATERFORD KIDS DENTAL CLUB, PLLC
This page provides the complete NPI Profile along with additional information for Waterford Kids Dental Club, Pllc, a provider established in Waterford, Michigan operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1689224818 assigned on September 2019. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Rebeca Urquiola Dds (Owner)
- NPI
- 1689224818 Verify this NPI
- Provider Name
- WATERFORD KIDS DENTAL CLUB, PLLC
- Entity Type
- Organization
- Location Address
- 3801 ELIZABETH LAKE RD WATERFORD, MI 48328
- Location Phone
- (248) 909-2132
- Mailing Address
- 4220 SURREY CROSS BLOOMFIELD HILLS, MI 48301
- Mailing Phone
- (248) 909-2132
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-19-2019
- Last Update Date
- 09-19-2019
- Code Navigator
A dentist like Waterford Kids Dental Club, Pllc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D0372415
- Facility Type
- Physician Office
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- DR. ESA M. ALI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Waterford Kids Dental Club, Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689224818, enumerated as an "organization" on September 19, 2019.
The provider is located at 3801 ELIZABETH LAKE RD WATERFORD, MI 48328 and the phone number is (248) 909-2132.
Dentist with taxonomy code 1223G0001X and a focus in General Practice.
