OrganizationActive
Pro Dental Mi 1 PC
NPI 1457188955 · Dentist · Detroit, MI
Pro Dental Mi 1 PC is a Dentist organization in Detroit, MI (NPI 1457188955).
Provider details
- NPI number
- 1457188955
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Simone Wilson-Adeleke, Director of Credentialing(732) 914-3991
Specialties & taxonomies
Dental Providers
- General Practice Dentistry1223G0001X
Dental Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
21427 Grand River Ave Ste 100
Detroit, MI 48219-3897
Phone: (313) 412-2100
Fax: (313) 766-7734
Street-level locationGet directions
Mailing address
10 Woodbridge Center Dr Ste 520
Woodbridge, NJ 07095-1152
Other names (DBA / former)
- Doing business as
- Destiny Dental of Grand River
Registry dates
- Enumerated
- 2024-09-18
- Last updated
- 2024-09-18
- Certified
- 2024-09-18
Frequently asked questions
- What is Pro Dental Mi 1 PC's NPI number?
- Pro Dental Mi 1 PC's National Provider Identifier (NPI) is 1457188955, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pro Dental Mi 1 PC?
- Pro Dental Mi 1 PC is classified in the NPPES registry as Dentist (Dental Providers).
- Where is Pro Dental Mi 1 PC located?
- Pro Dental Mi 1 PC's practice location on file with NPPES is 21427 Grand River Ave Ste 100, Detroit, MI 48219-3897.
- What is Pro Dental Mi 1 PC's phone number?
- The practice phone number listed in the NPPES registry for Pro Dental Mi 1 PC is (313) 412-2100.
- Who is the authorized official for Pro Dental Mi 1 PC?
- The authorized official listed on Pro Dental Mi 1 PC's NPPES record is Simone Wilson-Adeleke, Director of Credentialing. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pro Dental Mi 1 PC's NPI active?
- Yes — Pro Dental Mi 1 PC's NPI (1457188955) is active in the NPPES registry as of the last update on 2024-09-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.