SUMMIT ORAL & MAXILLOFACIAL SURGERY PC NPI 1811066129

NPI Information

  • NPI: 1811066129
  • Provider Name: SUMMIT ORAL & MAXILLOFACIAL SURGERY PC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • CLIA Number: 23D2160552
  • Address: 29427 RYAN RD
    WARREN, MI
    ZIP 48092
  • Phone: (586) 755-9340

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NPI Details

SUMMIT ORAL & MAXILLOFACIAL SURGERY PC is an oral and maxillofacial surgery dentist in Warren, 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. SUMMIT ORAL & MAXILLOFACIAL SURGERY PC NPI is 1811066129. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

29427 RYAN RD
WARREN, MI
ZIP 48092-203
Phone: (586) 755-9340
Fax: (586) 755-9341

The provider's authorized official is Jane M Windisch .
The authorized official title is Billing Specialist and has the following contact phone number (586) 755-9340.

The CLIA number assigned to this NPI record is 23D2160552 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 9/14/2009.

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 SurgeryYes

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
10E07680OTHERMICHIGANMEDICARE PTAN
2=========OTHERMICHIGANTAX ID
3970E076800OTHERMICHIGANBC

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: 11/21/2025

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