# REGENTS OF THE UNIVERSITY OF MICHIGAN SCHOOL OF DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124143300
- **Authorized official:** DR. ROMESH NALLIAH BDS (ASSOCIATE DEAN FOR PATIENT SERVICES)
- **Authorized official phone:** (888) 707-2500

## Contact information

- **Practice address:** 1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
- **Practice address phone:** (888) 707-2500
- **Practice address fax:** (734) 647-4024
- **Mailing address:** 1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
- **Mailing address phone:** (888) 707-2500
- **Mailing address fax:** (734) 647-4024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223P0300X | Periodontics | — | — | — |
| 1223P0700X | Prosthodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 1223X0008X | Oral and Maxillofacial Radiology Dentistry | — | — | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 126800000X | Dental Assistant | — | — | — |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 09/03/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 026194 | MIDWEST HEALTH | MI |
| 01 | — | 0985982 | HEALTH PLUS OF MI | MI |
| 01 | — | 190H11093 | BCBS OF MI MED SURGICAL | MI |
| 05 | — | 2667823 | — | OH |
| 01 | — | 43-29007 | PHP OF MI | MI |
| 05 | — | 4613082 | — | MI |
| 05 | — | 4615102 | — | MI |
| 01 | — | 88006 | DELTA OF MI GENL | MI |
| 01 | — | 970H11102 | BCBS OF MI MED SURGICAL | MI |
| 01 | — | D800336 | BCBS OF MI DENTAL | MI |
| 01 | — | DD81017 | M-CARE | MI |
| 01 | — | QMXPR0028409 | MOLINA HEALTHCARE OF MI | MI |