Healthcare Provider Details

I. General information

NPI: 1780096792
Provider Name (Legal Business Name): HYGIENIST RECOMMENDED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2014
Last Update Date: 08/03/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 12 MILE RD
BERKLEY MI
48072-1630
US

IV. Provider business mailing address

2790 12 MILE RD
BERKLEY MI
48072-1630
US

V. Phone/Fax

Practice location:
  • Phone: 248-439-0088
  • Fax: 248-439-2900
Mailing address:
  • Phone: 248-439-0088
  • Fax: 248-439-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901013810
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2902015237
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number2902015237
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE CANDICE PIETRASZEWSKI
Title or Position: PRESIDENT
Credential: RDH
Phone: 248-496-7447