Provider Demographics
NPI:1770217093
Name:KACHI, DONOVAN JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONOVAN
Middle Name:JOSEPH
Last Name:KACHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30079 KINGSWAY DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1711
Mailing Address - Country:US
Mailing Address - Phone:248-882-0578
Mailing Address - Fax:
Practice Address - Street 1:2738 WASHTENAW RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1506
Practice Address - Country:US
Practice Address - Phone:734-390-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016014741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice