# REGENTS OF THE UNIV OF MI COMMUNITY DENTAL CENTER

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

## Provider details

- **NPI number:** 1417072612
- **Authorized official:** DORIS J ALLEN DDS (DIRECTOR)
- **Authorized official phone:** (734) 998-9640

## Contact information

- **Practice address:** 406 N ASHLEY ST, ANN ARBOR, MI 48109-3308
- **Practice address phone:** (734) 998-9640
- **Practice address fax:** (734) 998-9647
- **Mailing address:** 406 N ASHLEY ST, ANN ARBOR, MI 48109-3308
- **Mailing address phone:** (734) 998-9640
- **Mailing address fax:** (734) 998-9647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 126800000X | Dental Assistant | — | NULL | — |
| 126800000X | Dental Assistant | — | — | — |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 88067 | DELTA DENTAL OF MI DENTIS | MI |
| 01 | — | 88129 | DELTA DENTAL OF MI PERIO | MI |
| 01 | — | D800484 | BCBS OF MI DENTAL | MI |