Healthcare Provider Details

I. General information

NPI: 1679404545
Provider Name (Legal Business Name): FAMILY DENTISTRY OF WEST BLOOMFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 FARMINGTON RD
WEST BLOOMFIELD MI
48322-4454
US

IV. Provider business mailing address

6400 FARMINGTON RD
WEST BLOOMFIELD MI
48322-4454
US

V. Phone/Fax

Practice location:
  • Phone: 248-661-4000
  • Fax: 248-661-4003
Mailing address:
  • Phone: 248-661-4000
  • Fax: 248-661-4003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHRISTA BURGER
Title or Position: OFFICE MANAGER
Credential:
Phone: 248-202-3751