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PRO DENTAL MI 1 PC
NPI 1912734286
Dentist - General Practice in Detroit, MI

Active since September 19, 2024
14736 MACK AVE, DETROIT, MI 48215(313) 412-2100(313) 766-7734 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pro Dental Mi 1 Pc NPPES

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

PRO DENTAL MI 1 PC (NPI 1912734286), doing business as Destiny Dental Of Mack, is a healthcare organization registered as a general practice in Detroit, Michigan and active in the NPI registry since September 2024. The organization lists Simone Wilson-adeleke, Director Of Credentialing, as its authorized official.

NPPES Registry Identity

NPI1912734286
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePRO DENTAL MI 1 PC
Location Address14736 MACK AVEDetroit, MI 48215-2524
Mailing Address10 Woodbridge Center Dr Ste 520Woodbridge, NJ 07095-1152 · (732) 731-8398
Phone(313) 412-2100
Fax(313) 766-7734
Organization SubpartNo
Authorized OfficialSimone Wilson-adelekeDirector Of Credentialing · (732) 731-8398
Enumeration DateSeptember 19, 2024
NPPES CertifiedSeptember 19, 2024
✔ NPI 1912734286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
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.
14736 MACK AVE, Detroit, MI 48215
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Other Names 1

Doing Business AsDestiny Dental Of Mack

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Other Providers at the Same Location NPPES 6

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

DR. SAMANTHA DEVLIN DDS
Dentist (General Practice)
14736 MACK AVE
DETROIT, MI 48215
Wayne County (313) 939-2127
AMERICA'S BEST CONTACTS & EYEGLASSES
Technician/Technologist (Optician)
14736 MACK AVE
DETROIT, MI 48215
Wayne County (313) 822-6053
RITIKA SHARMA DDS
Dentist
14736 MACK AVE
DETROIT, MI 48215
Wayne County (385) 259-3028
HARNEET KAUR DDS
Dentist
14736 MACK AVE
DETROIT, MI 48215
Wayne County (313) 939-2127
DR. SADE PARSONS DDS
Dentist (General Practice)
14736 MACK AVE
DETROIT, MI 48215
Wayne County (773) 456-7071
D2 DENTAL OF MICHIGAN, P.C.
Dentist (General Practice)
14736 MACK AVE
DETROIT, MI 48215
Wayne County (313) 412-2100

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 Pro Dental Mi 1 PC's NPI number?

The NPI number for Pro Dental Mi 1 PC is 1912734286. It was assigned to this organization in the NPPES registry on September 19, 2024. The provider is doing business as Destiny Dental of Mack.

Where is Pro Dental Mi 1 PC located?

Pro Dental Mi 1 PC is located at 14736 Mack Ave, Detroit, MI 48215. The listed phone number is (313) 412-2100.

What is Pro Dental Mi 1 PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Pro Dental Mi 1 PC accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Pro Dental Mi 1 PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pro Dental Mi 1 PC was last updated on September 19, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.