BERRO DENTAL GROUP (NPI# 1285884734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285884734 |
| Entity Type | Organization |
| Organization Name | BERRO DENTAL GROUP |
| Other Organization Name | KENNEDY DENTAL |
| Practice Address |
1193 Southfield Rd Lincoln Park MI 48146-2450 |
| Practice Telephone | 3133881800 |
| Practice Fax Number | 3133885527 |
| Mailing Telephone | 3133881800 |
| Mailing Fax Number | 3133885527 |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2008-09-22 |
| Authorized Official Name | DR. ABBAS HUSSEIN BERRO (DENTIST/PRESIDENT) |
| Authorized Official Telephone | 3133881800 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
2901019129 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4979625 | 05 |
| Other Name | Type Code |
|---|---|
| Kennedy Dental | Doing Business As Name - Organization |
| Street Address |
1193 SOUTHFIELD RD |
| City | LINCOLN PARK |
| State | MI |
| Zip Code | 48146-2450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366489452 | Abbas Hussein Berro | Dentist | 1193 Southfield Rd, Lincoln Park, MI 48146-2450 | 2006-05-31 |
| 1639544265 | Aziz Moukled | Dentist | 1193 Southfield Rd, Lincoln Park, MI 48146-2450 | 2015-12-08 |
| 1043623242 | Assia Mouabbi | Dentist | 1193 Southfield Rd, Lincoln Park, MI 48146-2450 | 2014-06-05 |
| 1619026085 | Kennedy Dental Center of Michigan, P.C. | Dentist | 1193 Southfield Rd, Lincoln Park, MI 48146-2450 | 2007-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356967251 | Luisa Sofia Amaya | Behavior Technician | 1360 Porter Ave, Lincoln Park, MI 48146 | 2020-06-17 |
| 1851854129 | Abhi Patel | Physical Therapist | 25050 W. Outer Dr, Ste: 204, Lincoln Park, MI 48146 | 2019-04-12 |
| 1831608827 | Back On Track Physical Therapy LLC | Clinic/Center | 1132 Southfield Road, Lincoln Park, MI 48146 | 2017-09-22 |
| 1326568221 | Priscilla Cano | Social Worker | 1600 Porter, Detroit, MI 48146 | 2017-06-21 |
| 1952650194 | Melissa Margaret Belinc | Psychologist | 26300 Outer Drive, Lincoln Park, MI 48146 | 2012-09-04 |
| 1497011746 | Richard John Daniels | Physical Therapy Assistant | 1538 Morris, Lincoln Park, MI 48146 | 2012-04-11 |
| 1740563261 | Myesha Renee Thurman | Social Worker | 26180 W. Outer Drive, Lincoln Park, MI 48146 | 2011-09-21 |
| 1033491162 | Heidi Bremer | Social Worker | 26180 West Outer Drive, Lincoln Park, MI 48146 | 2011-09-14 |
| 1871823526 | Richard Dale Mott | Counselor | 1564 Arlington, Lincoln Park, LA 48146 | 2009-12-31 |
| 1386801777 | Laura Ann Kaakati-weber | Psychologist | 26184 West Outer Drive, Lincoln Park, MI 48146 | 2008-05-22 |
| Find all providers in zip 48146 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710300702 | Dental Mentors | Clinic/Center | 166 Main St, Suite 1b, Lincoln Park, NJ 07035-3707 | 2014-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821216 | Inspired Family Dental Care | Clinic/Center | 1685 Fairholme Rd, Grosse Pointe Woods, MI 48236-2368 | 2020-11-05 |
| 1376144261 | Right Choice Dental, PC | Clinic/Center | 475 Columbia Ave E Ste 5, Battle Creek, MI 49014-5461 | 2020-11-05 |
| 1669073813 | Thomas M Smith, Dds, Plc | Clinic/Center | 755 Seminole Rd Ste 103, Norton Shores, MI 49441-6561 | 2020-11-04 |
| 1235739533 | Randy J Breen Dds Pllc | Clinic/Center | 2460 Burton St Se Ste 201, Grand Rapids, MI 49546-4800 | 2020-10-27 |
| 1831798370 | Saline Dental Care, Pllc | Clinic/Center | 150 Judd Rd, Milan, MI 48160-9584 | 2020-10-24 |
| 1235738113 | David Sorial Dds PC | Clinic/Center | 14755 Northline Rd, Southgate, MI 48195-2407 | 2020-10-21 |
| 1598363970 | Steven M Moss Dds PC | Clinic/Center | 37625 Ann Arbor Rd Ste 108, Livonia, MI 48150-2400 | 2020-10-16 |
| 1700484375 | Troy Cosmetic and Implant Dental Center Pllc | Clinic/Center | 4770 Rochester Rd Ste 106, Troy, MI 48085-4951 | 2020-10-15 |
| 1194323303 | Aq Dental Group Pllc | Clinic/Center | 10413 Ford Road, Units M & N, Dearborn, MI 48126 | 2020-10-12 |
| 1245837806 | Kendall J Lee Dds Pllc | Clinic/Center | 111 S Howell St, Hillsdale, MI 49242-1873 | 2020-10-07 |
| Find all providers with the same taxonomy | ||||
| City | LINCOLN PARK |
| Zip Code | 48146 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.