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MICHIGAN OMS P C NPI 1801906458


NPI Information

NPI: 1801906458
Provider Name: MICHIGAN OMS P C
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
6022 W MAPLE RD STE 405
WEST BLOOMFIELD, MI
ZIP 48322
Phone: (248) 855-2006
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MICHIGAN OMS P C 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. MICHIGAN OMS P C NPI is 1801906458. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6022 W MAPLE RD STE 405
WEST BLOOMFIELD, MI
ZIP 48322-408
Phone: (248) 855-2006
Fax: (248) 855-0571

The provider's authorized official is Nicholas J Bournias .
The authorized official title is President and has the following contact phone number (586) 228-9070.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 1/17/2024.


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
11223S0112XDentistOral and Maxillofacial SurgeryMICHIGANYes

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 Other Provider Identifier Issuer
12901020355OTHERMICHIGANSTATE LICENSE NUMBER
23159052MEDICAIDMICHIGAN
34067429MEDICAIDMICHIGAN
42990516MEDICAIDMICHIGAN
52990561MEDICAIDMICHIGAN
62773480MEDICAIDMICHIGAN
7970F31085OTHERMICHIGANGROUP NUMBER BCBSM
8NB015573OTHERMICHIGANSTATE LICENSE NUMBER
91021382MEDICAIDMICHIGAN
103203473MEDICAIDMICHIGAN
112990552MEDICAIDMICHIGAN

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

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