Provider Demographics
NPI:1720786783
Name:HEALTHY SKIN PLLC
Entity Type:Organization
Organization Name:HEALTHY SKIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-877-7777
Mailing Address - Street 1:5364 W DOHERTY DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2708
Mailing Address - Country:US
Mailing Address - Phone:313-877-7777
Mailing Address - Fax:
Practice Address - Street 1:2550 S TELEGRAPH RD STE 104
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0951
Practice Address - Country:US
Practice Address - Phone:248-972-5143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty