Healthcare Provider Details

I. General information

NPI: 1508781519
Provider Name (Legal Business Name): BARNUM STREET DENTAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BARNUM ST
DUNDEE MI
48131-1110
US

IV. Provider business mailing address

120 RIVER PARK PL
DUNDEE MI
48131-2026
US

V. Phone/Fax

Practice location:
  • Phone: 734-244-9011
  • Fax:
Mailing address:
  • Phone: 734-244-9011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL TODD VALENTINE
Title or Position: OWNER/SOLE MBR
Credential: D.D.S.
Phone: 734-244-9011