CMS-1500 Box 24J / 33a • NPI
1528064771
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
305S00000X
Licensed & Credentialed Point of Service
Box 32 Service Location & ZIP+4
17128 FORT ST, RIVERVIEW, MI, 48193-6619
✓ 9-Digit EDI 837 ZIP+4 (48193-6619)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1528064771 (A DENTAL CENTER-DOWNRIVER) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1528064771 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | A DENTAL CENTER-DOWNRIVER |
| Plain-English Specialty | Licensed & Credentialed Point of Service NUCC Code: 305S00000X (Point of Service) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 17128 FORT ST, RIVERVIEW, MI, 48193-6619 |
| Practice Telephone / Fax | Tel: (734) 281-3200 | Fax: (734) 281-3890 |
| Administrative Mailing Address | 17128 FORT ST, RIVERVIEW, MI, 48193-6619 |
| Enumeration & Last Sync | Enumerated: 2005-06-22 | CMS Record Updated: 2007-09-05 |
| Authorized Official | HOWARD POTOCSKY (billing) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (305S00000X)
What Does Taxonomy Code 305S00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 305S00000X translates to:
"Licensed & Credentialed Point of Service"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (A DENTAL CENTER-DOWNRIVER)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
305S00000X — Point of ServicePlain English: Licensed & Credentialed Point of Service | State: MI | License: 17288 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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