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General NPI Number Information
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NPI Number | 1124143300
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIVERSITY OF MICHIGAN SCHOOL OF DENTISTRY
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 09/03/2021
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Provider Practice Location Address
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Address Line | 1011 N UNIVERSITY AVE
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City | ANN ARBOR
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State | MI
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Zip | 48109-1078
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Country | US
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Telephone | 888-707-2500
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Fax | 734-647-4024
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Provider Business Mailing Address
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Address Line | 1011 N UNIVERSITY AVE
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City | ANN ARBOR
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State | MI
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Zip | 48109-1078
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Country | US
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Telephone | 888-707-2500
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Fax | 734-647-4024
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Authorized Official
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Title or Position | ASSOCIATE DEAN FOR PATIENT SERVICES
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Name | DR. ROMESH NALLIAH
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Credential | BDS
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Telephone | 888-707-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223X0008X
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Taxonomy Name | Oral and Maxillofacial Radiology Dentistry
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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