Organization
DIRECT OPTICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS IRA CHAIKEN (PRESIDENT)
(248) 553-8270
Entity
Organization
Contact information
Practice address
29321 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48334-2968
(248) 553-8270
(248) 553-8185
Mailing address
29321 ORCHARD LAKE RD, FARMINGTON HILLS, MI 48334-2968
(248) 553-8270
(248) 553-8185
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230266
NATIONAL VISION ADMIN.
—
01
—
900F376990
BLUE CROSS BLUE SHIELD
MI
01
—
CP2724
EYE MED
—
01
—
VC630014
M-CARE
—
Enumeration date
02/27/2006
Last updated
04/26/2012
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