Individual
JOSE L VIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 647-4149
(734) 936-1597
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 647-4149
(734) 936-1597
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901017071
MI
1223G0001X
General Practice Dentistry
2901017071
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D170710
BCBS OF MI DENTAL
MI
Enumeration date
03/19/2007
Last updated
09/11/2025
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