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

Pro Dental Mi 1 PC

Organization Dentist · NPI 1457188955

Pro Dental Mi 1 PC is a Dentist in Detroit, Michigan. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

21427 Grand River Ave Ste 100
Detroit, MI 48219-3897
Phone: (313) 412-2100
Fax: (313) 766-7734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X
General Practice Dentistry Taxonomy 1223G0001X

Record details

NPI number1457188955
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Simone Wilson-Adeleke — Director Of Credentialing · (732) 914-3991
Other names Destiny Dental Of Grand River
NPI enumeratedSeptember 18, 2024
Last updated in NPPESSeptember 18, 2024
Certification dateSeptember 18, 2024
Mailing address10 Woodbridge Center Dr Ste 520, Woodbridge, NJ 07095-1152

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