PERIODONTAL SPECIALTIES NPI 1346428026

NPI Information

  • NPI: 1346428026
  • Provider Name: PERIODONTAL SPECIALTIES
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • Address: 8130 CONSTITUTION BLVD
    STERLING HEIGHTS, MI
    ZIP 48313
  • Phone: (586) 268-5520

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NPI Details

PERIODONTAL SPECIALTIES is a periodontics dentist in Sterling Heights, MI. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTAL SPECIALTIES NPI is 1346428026. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

8130 CONSTITUTION BLVD
STERLING HEIGHTS, MI
ZIP 48313-801
Phone: (586) 268-5520

The provider's authorized official is Jeffery Johnston .
The authorized official title is President and has the following contact phone number (586) 268-5520.

The enumeration date for this NPI number is 2/5/2008 and was last updated on 2/5/2008.

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
11223P0300XDentistPeriodontics13303MICHIGANYes

What is NPI?

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This page was last updated on: 3/30/2025

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