Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Primesource of Michigan LLC

Organization Dentist · NPI 1114364346

Primesource of Michigan LLC is a Dentist in Southfield, Michigan. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2000 Town Ctr Ste 1900
Southfield, MI 48075-1135
Phone: (800) 317-0711
Fax: (877) 821-6402
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X
Dentist Taxonomy 122300000X
Optometrist Taxonomy 152W00000X
Audiologist Taxonomy 231H00000X

Record details

NPI number1114364346
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Fleming — Ceo/President · (800) 317-0711
NPI enumeratedMay 29, 2013
Last updated in NPPESMay 29, 2013
Mailing address2100 E Lake Cook Rd, Suite 1100, Buffalo Grove, IL 60089-1999

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