Provider Demographics
NPI:1235243965
Name:OAKWOOD DENTAL PC
Entity Type:Organization
Organization Name:OAKWOOD DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAMPARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-563-3300
Mailing Address - Street 1:18181 OAKWOOD BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-4082
Mailing Address - Country:US
Mailing Address - Phone:313-563-3300
Mailing Address - Fax:313-982-1812
Practice Address - Street 1:18181 OAKWOOD BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4082
Practice Address - Country:US
Practice Address - Phone:313-563-3300
Practice Address - Fax:313-982-1812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI083161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2623286Medicaid
U23483Medicare UPIN
5826441Medicare ID - Type Unspecified