LEGACY DENTAL GROUP, PC


Address: 950 S Old Woodward Ave Ste 200, Birmingham, MI 48009-6719
Phone: 2486449120

LEGACY DENTAL GROUP, PC (NPI# 1477894442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477894442
Entity Type Organization
Organization Name LEGACY DENTAL GROUP, PC
Other Organization Name LEGACY DENTAL GROUP
Practice Address 950 S Old Woodward Ave Ste 200
Birmingham
MI 48009-6719
Practice Telephone 2486449120
Practice Fax Number 2482825060
Mailing Telephone 2486449120
Mailing Fax Number 2482825060
Enumeration Date 2013-03-15
Last Update Date 2019-04-10
Authorized Official Name DR. JEFFREY C. GRABIEL (OWNER/DENTIST)
Authorized Official Telephone 2486443131
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
012169 MI Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Legacy Dental Group Doing Business As Name - Organization

Office Location

Street Address 950 S OLD WOODWARD AVE STE 200
City BIRMINGHAM
State MI
Zip Code 48009-6719

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NPI Name Taxonomy Address Enumeration
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1578956348 Nancy Jane Naski Recreation Therapist 623 Hanna St, Birmingham, MI 48009 2015-03-18
1619370236 Caitlin Stoltman Recreation Therapist 1669 W. Maple Rd., Far, Birmingham, MI 48009 2014-09-28
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1235560764 Better Life Learning Community/Behavioral Health 33717 Woodward Ave #253, Birmingham, MI 48009 2013-12-10
1689949034 Drs Housecalls PC Internal Medicine 298 S. Old Woodward, Birminham, MI 48009 2012-03-19
1689942021 Brian Connolly Md PC Psychiatry & Neurology 189 Townsend, Suite 300, Birmingham, MI 48009 2011-12-13
1619204187 Dr. Lori PC Dermatology 353 South Old Woodward Ave, Birmingham, MI 48009 2009-11-04
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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952934226 Red Mountain Pediatric Dentistry Clinic/Center 2836 Lakeshore Pkwy, Birmingham, AL 35211-5500 2020-02-14
1467085837 Brooke Jordan Dds LLC Clinic/Center 101 Missionary Rdg Ste 101, Birmingham, AL 35242-5203 2020-02-13
1790275840 Magic City Dentistry, PC Clinic/Center 2117 1st Ave N, Birmingham, AL 35203-4201 2018-05-15
1679075600 Iron City Dentistry P.C. Clinic/Center 220 Walker Rd, Birmingham, AL 35214-3138 2018-03-06
1265946321 Ronald Alyn Macbeth Dmd, LLC Clinic/Center 1045 Broadway Park, Suite 101, Birmingham, AL 35209-3520 2017-11-28
1942710983 Southern Dental Sleep Specialists LLC Clinic/Center 4960 Valleydale Rd Ste 100, Birmingham, AL 35242 2017-10-04
1346769114 Dr. Clark Thomas, PC Clinic/Center 721 Montclair Rd, Birmingham, AL 35213-1905 2017-09-13
1316296783 Morgan Dentistry Clinic/Center 2512 D Rocky Ridge Road, Birmingham, AL 35243-2433 2012-08-31
1053669648 Advance Dental, P.C. Clinic/Center 242 West Valley Avenue Suite 101, Birmingham, AL 35209-3635 2012-08-29
1255650115 Caldwell Crossings Dentistry Clinic/Center 4516 Valleydale Road, Birmingham, AL 35242 2010-05-18
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Competitor

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City BIRMINGHAM
Zip Code 48009

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Dataset Information

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.

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