RICHARD J PERSIANI DDS MS NPI 1770625055

NPI Information

NPI: 1770625055
Provider Name: RICHARD J PERSIANI, DDS MS
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

Address:
6177 ORCHARD LAKE ROAD
SUITE #120
WEST BLOOMFIELD, MI
ZIP 48322
Phone: (248) 855-6655
Get Directions

Richard J Persiani, DDS MS is an oral and maxillofacial surgery dentist in West Bloomfield, MI. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Richard J Persiani, DDS MS NPI is 1770625055. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6177 ORCHARD LAKE ROAD
SUITE #120
WEST BLOOMFIELD, MI
ZIP 48322
Phone: (248) 855-6655
Fax: (248) 855-0803

The enumeration date for this NPI number is 2/13/2007 and was last updated on 3/7/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		D10565	MICHIGAN	No
2	204E00000X	Oral & Maxillofacial Surgery		2901010565	MICHIGAN	No
3	1223P0700X	Dentist	Prosthodontics	2901010565	MICHIGAN	No
4	1223S0112X	Dentist	Oral and Maxillofacial Surgery	2901010565	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	5636930	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN
2	P20352	MEDICARE UPIN
3	2758821	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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