Diversified Dental, P.C.
NPI 1669191342 · Dental Clinic/Center · Saint Clair Shores, MI
Diversified Dental, P.C. is a Dental Clinic/Center organization in Saint Clair Shores, MI (NPI 1669191342).
Provider details
- NPI number
- 1669191342
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kevin Prush, Dentist(586) 775-2400
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs 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
Mailing address
Registry dates
- Enumerated
- 2022-08-25
- Last updated
- 2022-08-25
- Certified
- 2022-08-25
Frequently asked questions
- What is Diversified Dental, P.C.'s NPI number?
- Diversified Dental, P.C.'s National Provider Identifier (NPI) is 1669191342, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Diversified Dental, P.C.?
- Diversified Dental, P.C. is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Diversified Dental, P.C. located?
- Diversified Dental, P.C.'s practice location on file with NPPES is 30231 Jefferson Ave, Saint Clair Shores, MI 48082-1787.
- What is Diversified Dental, P.C.'s phone number?
- The practice phone number listed in the NPPES registry for Diversified Dental, P.C. is (586) 775-2400.
- Who is the authorized official for Diversified Dental, P.C.?
- The authorized official listed on Diversified Dental, P.C.'s NPPES record is Kevin Prush, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Diversified Dental, P.C.'s NPI active?
- Yes — Diversified Dental, P.C.'s NPI (1669191342) is active in the NPPES registry as of the last update on 2022-08-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.